Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | .03358-NP | OH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 61181-COA-1 | OH |
NPI | 1194116087 |
---|---|
Provider Name | Debora Krendl |
First Address | Lima, OH 45801-4602 |
Second Address | Lima, OH 45801-4602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2015 |
Last Update Date | 28/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0121150 | (05) | OH |