Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | APRN.CNP.024547 | OH |
NPI | 1023583242 |
---|---|
Provider Name | Maggie Marie Pelle |
First Address | Cincinnati, OH 45206-1785 |
Second Address | Cincinnati, OH 45213-2674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2018 |
Last Update Date | 10/10/2019 |