Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | NP06962 | OH |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NP06962 | OH |
NPI | 1043349517 |
---|---|
Provider Name | Mrs. Angela Renee Hoersting |
First Address | Dayton, OH 45404-1898 |
Second Address | Dayton, OH 45404-1898 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3021223 | (05) | OH |