Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.020085 | OH |
NPI | 1003352394 |
---|---|
Provider Name | Kayla Borchers |
First Address | Greenville, OH 45331-1180 |
Second Address | Greenville, OH 45331-1180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2017 |
Last Update Date | 11/01/2017 |