Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0028739 | OH |
N | 363LA2200X | Nurse Practitioner - Adult Health | 0028739 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 0028739 | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | 0028739 | OH |
NPI | 1023686185 |
---|---|
Provider Name | Leah Blum |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2021 |
Last Update Date | 03/07/2021 |