Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | COA.18539-NP | OH |
NPI | 1013372564 |
---|---|
Provider Name | Holly A Archer |
First Address | Cincinnati, OH 45263-6930 |
Second Address | Lima, OH 45805-1705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2015 |
Last Update Date | 02/03/2016 |