Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN.CNP.06719 | OH |
N | 363LA2200X | Nurse Practitioner - Adult Health | COA.06719-NP | OH |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | NP167311 | OH |
NPI | 1174536379 |
---|---|
Provider Name | Ruthann C. Kennedy |
First Address | Columbus, OH 43202-1579 |
Second Address | Columbus, OH 43221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 26/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2333880 | (05) | OH |
P64311 | (02) | OH |