Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | COA.03085-NP | OH |
NPI | 1043332141 |
---|---|
Provider Name | Nan E. Tobias |
First Address | Toledo, OH 43604-7101 |
Second Address | Toledo, OH 43608-2673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 10/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2734170 | (05) | OH |