Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | NP07438 | OH |
NPI | 1194711200 |
---|---|
Provider Name | Roberta S Harding |
First Address | Toledo, OH 43624-1120 |
Second Address | Toledo, OH 43608-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2462142 | (05) | OH |