Individual
TYE CHRISTIAN NORBERT PANKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 807-7055
Mailing address
5652 BRIDGETOWN RD APT 22, CINCINNATI, OH 45248-4365
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
407866
OH
363L00000X
Nurse Practitioner
Primary
0029475
OH
Other
Enumeration date
04/16/2021
Last updated
12/27/2021
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