Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN.CNP.0029068 | OH |
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.0029068 | OH |
NPI | 1033787916 |
---|---|
Provider Name | Cosette E. Tolley |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43201-3620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2021 |
Last Update Date | 27/09/2021 |