Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APRN.CNP.0026753 | OH |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | APRN.CNP.0026753 | OH |
NPI | 1225651029 |
---|---|
Provider Name | Stephanie Gwin |
First Address | Toledo, OH 43604-1558 |
Second Address | Toledo, OH 43606-3895 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2020 |
Last Update Date | 30/01/2021 |