Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | COA.17212-NP | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | COA.17212-NP | OH |
NPI | 1043698780 |
---|---|
Provider Name | Mrs. Samantha Ashley Meeson |
First Address | Cleveland, OH 44106-1716 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 14/05/2015 |