| NPI | 1023564143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M HEMKER Credentialinglorainhealth Dentistry 440-240-1655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 207Q00000X Family Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2019-08-14 |