Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NP-01697 | OH |
NPI | 1023215126 |
---|---|
Provider Name | Mrs. Anne Bagshaw |
First Address | Greendale, IN 47025-1535 |
Second Address | Cincinnati, OH 45204-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 17/03/2018 |