Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP-09414 | OH |
Y | 363LG0600X | Nurse Practitioner - Gerontology | NP-09414 | OH |
NPI | 1043533763 |
---|---|
Provider Name | Dr. Carolyn Harmon Still |
First Address | Richmond Heights, OH 44143-2565 |
Second Address | Shaker Heights, OH 44120-5376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2010 |
Last Update Date | 11/12/2013 |