Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | COA 09633-NP | OH |
NPI | 1164667614 |
---|---|
Provider Name | Ms. Krista Dawn Plato |
First Address | Blacklick, OH 43004-7132 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2008 |
Last Update Date | 12/12/2008 |