Healthcare Provider Details

I. General information

NPI: 1457775421
Provider Name (Legal Business Name): MS. CYNTHIA STENGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2014
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2556 LEBANON RD
CLARKSVILLE OH
45113-8201
US

IV. Provider business mailing address

2556 LEBANON RD
CLARKSVILLE OH
45113-8201
US

V. Phone/Fax

Practice location:
  • Phone: 937-289-2109
  • Fax: 937-289-3313
Mailing address:
  • Phone: 937-289-2109
  • Fax: 937-289-3313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN221974
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: