Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 14240 | OH |
NPI | 1003155722 |
---|---|
Provider Name | Karen Rekos |
First Address | Cincinnati, OH 45242-4402 |
Second Address | Cincinnati, OH 45242-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2013 |
Last Update Date | 11/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0100271 | (05) | OH |