Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 15054 | OH |
Y | 363L00000X | Nurse Practitioner | APN.0994384-NP | CO |
NPI | 1003240862 |
---|---|
Provider Name | Sumy Anthony |
First Address | Cleveland, OH 44195-0001 |
Second Address | Denver, CO 80218-1200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2013 |
Last Update Date | 16/03/2020 |