Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125-052562 | IL |
N | 207V00000X | Obstetrician & Gynecologist | 69354 | MN |
Y | 207V00000X | Obstetrician & Gynecologist | PT 12031 | ND |
NPI | 1003006651 |
---|---|
Provider Name | Zena Kay Homan |
First Address | Fargo, ND 58108-6001 |
Second Address | Fargo, ND 58103-6132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16201 | (05) | ND |