Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.025749 | OH |
NPI | 1013540483 |
---|---|
Provider Name | Laura Nikole Erskine Penix |
First Address | Painesville, OH 44077-2508 |
Second Address | Beachwood, OH 44122-1191 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2020 |
Last Update Date | 13/02/2020 |