Individual provider · Type 1 NPI
Ni Ketut Kumala Dewi Hariadi
Nurse Practitioner · Independence, OH
Practice location
5001 Rockside Rd
Independence, OH 44131-2172
Mailing address
9000 Moss Pointe Cir
Olmsted Township, OH 44138-8168
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | AG07180050 (OH) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1114404159
Ni Ketut Kumala Dewi Hariadi's National Provider Identifier is 1114404159, issued on Jul 23, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Independence, OH. The record was last updated on Jul 23, 2018.