Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0030463 | OH |
NPI | 1063171734 |
---|---|
Provider Name | Sarah Lynn Matheny |
First Address | Holgate, OH 43527-9719 |
Second Address | Lima, OH 45801-4602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2021 |
Last Update Date | 05/01/2022 |