Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN.CNP.021345 | OH |
NPI | 1013430032 |
---|---|
Provider Name | Ms. Christine Mulombe Skoda |
First Address | Cleveland, OH 44113-3108 |
Second Address | Cleveland, OH 44113-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2017 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
APRN.CNP.021345 | OHIO BOARD OF NURSING (01) | OH |