Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.023590 | OH |
NPI | 1003398942 |
---|---|
Provider Name | Resha Vatty |
First Address | Chardon, OH 44024-8945 |
Second Address | Cleveland, OH 44195-1078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2018 |
Last Update Date | 25/09/2018 |