Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | COA.14678-NP | OH |
NPI | 1083054449 |
---|---|
Provider Name | Ms. Lindsay Anne Bizzaro |
First Address | Powell, OH 43065-9504 |
Second Address | Norwich, CT 06360-2740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 17/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0089320 | (05) | OH |