Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.0030324 | OH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 0030324 | OH |
NPI | 1043893506 |
---|---|
Provider Name | Jaimie Kathleen Eisenhart |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205-2639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2021 |
Last Update Date | 14/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0468483 | (05) | OH |