Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | COA.06835-NP | OH |
N | 363LA2100X | Nurse Practitioner - Acute Care | NP-3855P | KY |
NPI | 1013059559 |
---|---|
Provider Name | Deborah Elaine Bliss |
First Address | Crestview Hills, KY 41017 |
Second Address | Edgewood, KY 41017-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP-06835 | OHIO NP LICENSE (01) | OH |