Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN.CNP.020913 | OH |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | APRN.CNP.020913 | OH |
NPI | 1023522976 |
---|---|
Provider Name | Sarah K. Driesbach |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0253767 | (05) | OH |
H601660 | CGS MEDICARE (01) | OH |