Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 11258-NP | OH |
NPI | 1083945109 |
---|---|
Provider Name | Colleen M Kwiatkowski |
First Address | Toledo, OH 43606-3895 |
Second Address | Toledo, OH 43606-3895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2010 |
Last Update Date | 27/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2058142 | (05) | OH |