| NPI | 1417298589 |
|---|---|
| Former Name | CHANEL NICOLE NIDA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: OH NP14352) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH 14352) |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2016-09-07 |