Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | NP-09174 | OH |
NPI | 1124169172 |
---|---|
Provider Name | Lisa Robinson Jasin |
First Address | Dayton, OH 45458-9441 |
Second Address | Dayton, OH 45404-1898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |