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General NPI Number Information
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NPI Number | 1518909415
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Entity Type | Individual
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Provider Name | PAULA NICOLE KOSTUIK NEIDHARD CNP
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Gender | Female
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 10506A MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-4402
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Country | US
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Telephone | 513-853-1300
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Fax | 513-451-4118
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Provider Business Mailing Address
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Address Line | 10506A MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-4402
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Country | US
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Telephone | 513-853-1300
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Fax | 513-451-4118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R152392
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | COA.18800-NP
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.18800
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License Number State | OH
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