Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 021185 | OH |
NPI | 1003339623 |
---|---|
Provider Name | Kathryn Lynn Alto |
First Address | Bedford, OH 44146-2711 |
Second Address | Bedford, OH 44146-2711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2017 |
Last Update Date | 30/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0243684 | (05) | OH |