Individual
PAULA NICOLE KOSTUIK NEIDHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
10506A MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 853-1300
(513) 451-4118
Mailing address
10506A MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 853-1300
(513) 451-4118
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R152392
MD
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.18800
OH
363LA2100X
Acute Care Nurse Practitioner
COA.18800-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402732900
—
MD
01
—
G010 /
BLUECHOICE
MD
01
—
KDA7 /
BC / BS OF MD
MD
Enumeration date
06/12/2006
Last updated
10/17/2024
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