Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0089930 | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN.396617 | OH |
NPI | 1528730702 |
---|---|
Provider Name | Mr. Christopher Reed Ewry |
First Address | Toledo, OH 43604-1531 |
Second Address | Toledo, OH 43606-3895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2021 |
Last Update Date | 08/10/2021 |