Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | NP17496 | OH |
NPI | 1023494952 |
---|---|
Provider Name | Mrs. Kathryn Elizabeth Rosenbeck |
First Address | Sidney, OH 45365-2401 |
Second Address | Sidney, OH 45365-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2015 |
Last Update Date | 08/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0140653 | (05) | OH |