Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | RN.393586 | OH |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN.CNP.021013 | OH |
NPI | 1053831099 |
---|---|
Provider Name | Hannah Bostdorff |
First Address | Cleveland, OH 44195-2401 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2017 |
Last Update Date | 08/11/2021 |