Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP9337862 | FL |
Y | 363L00000X | Nurse Practitioner | COA09545 | OH |
NPI | 1003001686 |
---|---|
Provider Name | Jennifer Dawn Trost |
First Address | Toledo, OH 43604-7101 |
Second Address | Toledo, OH 43608-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2007 |
Last Update Date | 27/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015224300 | (05) | FL |
2834302 | (05) | OH |
NP82171 | (05) | OH |
Y0R0N | BLUE CROSS BLUE SHIELD (01) | FL |