NPI | 1619304086 |
---|---|
Former Name | MICHELLE PENNINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.14779) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH APRN.CNP.14779) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.14779-NP) | |
Enumeration Date | 2013-10-01 |
Last Update Date | 2024-01-22 |