Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 47742 | MN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2011-00362 | NC |
N | 207VX0201X | Gynecologic Oncologist | 47742 | MN |
NPI | 1053384149 |
---|---|
Provider Name | Joshua Franklin Nitsche |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 24/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
974686200 | (05) | MN |
I36050 | (02) |