Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.022967 | OH |
NPI | 1053897330 |
---|---|
Provider Name | Caroline Nicole Holden |
First Address | Dublin, OH 43016-6102 |
Second Address | Columbus, OH 43215-4701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2018 |
Last Update Date | 19/07/2018 |