Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | COA.04860-NP | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN212093 | OH |
NPI | 1275647893 |
---|---|
Provider Name | Gretchen Whitby |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43221-3502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 26/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2663443 | (05) | OH |
Q63727 | (02) |