Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN.CNP.023286 | OH |
NPI | 1063076412 |
---|---|
Provider Name | Mrs. Inna L Bair |
First Address | Middletown, OH 45042-9506 |
Second Address | Middletown, OH 45042-9506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2019 |
Last Update Date | 30/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AGPCNP-BC | NP CERTIFICATION (01) | |
APRN.CNP.023286 | NP LICENSE (01) | OH |
RN.381291 | RN LICENSE (01) | OH |