Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704243006 | MI |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 352360 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 352360 | OH |
NPI | 1053778332 |
---|---|
Provider Name | Mrs. Tonisha Monique Harrison |
First Address | Toledo, OH 43623-1906 |
Second Address | Toledo, OH 43606-3895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2016 |
Last Update Date | 28/10/2020 |