Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 14273317 | OH |
NPI | 1003301516 |
---|---|
Provider Name | Lisa Bainter |
First Address | Toledo, OH 43606-5111 |
Second Address | Toledo, OH 43606-5111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2018 |
Last Update Date | 27/06/2018 |