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Registrant NPI Number: 1598096489

Individual Registrant:
Gender: F
Sole Proprietor

Location and contact information for practice:
11405 DOZER RD SW  STOUTSVILLE, OH 43154-9732 US
Tel: 740-412-1065  Fax: --

Contact information for business:
11405 DOZER RD SW  STOUTSVILLE, OH 43154-9732 US
Tel: 740-412-1065  Fax: --

Registration Information:
NPI: 1598096489
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163W00000XNursing Service Providers
Registered Nurse

Legacy codes, insurance codes and state license numbers:



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