Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN.CNP.023199 | OH |
NPI | 1003300062 |
---|---|
Provider Name | Raina Ann Vretenar |
First Address | Columbus, OH 43220-4543 |
Second Address | Columbus, OH 43081-8070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2018 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RN.351152 | RN (01) | OH |