Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | NP-11192 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | NP-11192 | OH |
NPI | 1073841425 |
---|---|
Provider Name | Patty Hui Chan |
First Address | Cleveland, OH 44106-1716 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2009 |
Last Update Date | 23/11/2009 |