Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRNCNP0030061 | OH |
NPI | 1164199816 |
---|---|
Provider Name | Kaitlyn Hillary Marie Vincent |
First Address | Toledo, OH 43608-2603 |
Second Address | Toledo, OH 43608-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2021 |
Last Update Date | 05/11/2021 |