Facts
- Status
- A
- Credential
- FNP
- Type
- Individual
- Enumeration date
- 2014-10-27
- Last updated
- 2018-10-18
Specialties
Licenses
- License OH
- APRN.CNP.019799
Location
- Practice location
- 830 S MAIN ST
- City
- ORRVILLE OH
- Postal code
- 446672291
- Phone
- 330-684-2015
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.