Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN.CNP.023014 | OH |
NPI | 1023580339 |
---|---|
Provider Name | Lynne Zachman |
First Address | Bowling Green, OH 43402-1600 |
Second Address | Bowling Green, OH 43402-2652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2018 |
Last Update Date | 27/12/2018 |