Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | NP 06023 | OH |
NPI | 1073757514 |
---|---|
Provider Name | Mrs. Laura Jane Bobek |
First Address | Amherst, OH 44001-1966 |
Second Address | Cleveland, OH 44111-5612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 28/04/2009 |