Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | COA 14551 NP | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | COA 14551-NP | OH |
NPI | 1063851442 |
---|---|
Provider Name | Lillian S Nagi |
First Address | Sylvania, OH 43560-2269 |
Second Address | Oregon, OH 43616-4921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2013 |
Last Update Date | 04/11/2014 |