Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN-141891 | OH |
NPI | 1013138387 |
---|---|
Provider Name | Karen Caputo |
First Address | Perrysburg, OH 43551-3429 |
Second Address | Toledo, OH 43606-3895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 01/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2240711 | (05) | OH |
4446841 | (05) | MI |
810547599041 | CARESOURCE (01) | OH |
P21008 | (02) | OH |