Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRN.CNP.019855 | OH |
N | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.019855 | OH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APRN.CNP.019855 | OH |
NPI | 1104374438 |
---|---|
Provider Name | Shannon Patton-Baker |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2016 |
Last Update Date | 11/05/2018 |