MEDICARE: PHYLLIS ANNE DUNBAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	401019341209	OH

General Provider Information

NPI Number	:	1821336231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLLIS ANNE DUNBAR

Provider Business Mailing Address
First Line	:	PO BOX 12621
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-0621
Country	:	US
Telephone Number	:	513-388-7064
Fax Number	:

Provider Business Practice Location Address
First Line	:	3225 WESTBROOK DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2220
Country	:	US
Telephone Number	:	513-388-7064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2013
Last Update Date	:	01/18/2013

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