Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 29, 2016
License(s)
RN356576 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1550 YANKEE PARK PL | Dayton, OH 45458-1868 | 937-439-4949 |
| MAILING | 1238 MITMAN DR | Fairborn, OH 45324-5572 |
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