Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 14356 | OH |
NPI | 1023452844 |
---|---|
Provider Name | Susan E Reif |
First Address | Independence, OH 44131-5057 |
Second Address | Independence, OH 44131-5057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2013 |
Last Update Date | 24/04/2013 |