Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | APRNCNP021065 | OH |
N | 363LA2100X | Nurse Practitioner - Acute Care | 021065 | OH |
NPI | 1033639935 |
---|---|
Provider Name | Zachary Michael Novotni |
First Address | Columbus, OH 43204-3842 |
Second Address | Columbus, OH 43221-3502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2017 |
Last Update Date | 25/07/2017 |