Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRNCNP17918 | OH |
NPI | 1033595673 |
---|---|
Provider Name | Kadi Lepi Addy |
First Address | Zanesville, OH 43701-2836 |
Second Address | Cambridge, OH 43725-9614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2015 |
Last Update Date | 31/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0142341 | (05) | OH |