Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN.CNP.024719 | OH |
N | 363LC1500X | Nurse Practitioner - Community Health | APRN.CNP.024719 | OH |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.024719 | OH |
N | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.024719 | OH |
NPI | 1104487438 |
---|---|
Provider Name | Mr. Michael A Frost JR. |
First Address | Columbus, OH 43203-1874 |
Second Address | Columbus, OH 43203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 03/09/2019 |