Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | COA.16706-NP | OH |
N | 363LP0222X | Nurse Practitioner Pediatrics (Critical Care) | 16706 | OH |
NPI | 1033514963 |
---|---|
Provider Name | Ms. Christine Halishak |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-5387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 07/11/2019 |