Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 3005868 | KY |
Y | 363LW0102X | Nurse Practitioner - Women's Health | 09800 | OH |
NPI | 1043492267 |
---|---|
Provider Name | Marcelle Bobst |
First Address | Florence, KY 41042-1513 |
Second Address | Florence, KY 41042-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2007 |
Last Update Date | 13/01/2011 |