Healthcare Provider Details

I. General information

NPI: 1922871508
Provider Name (Legal Business Name): JUANITA MARGUERITE KRISHER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W GRAND AVE STE 3002
DAYTON OH
45405-4722
US

IV. Provider business mailing address

729 W GRAND AVE APT 405
DAYTON OH
45406-5334
US

V. Phone/Fax

Practice location:
  • Phone: 937-723-4231
  • Fax: 937-723-4545
Mailing address:
  • Phone: 937-623-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLE-00049263
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberAPRN.CNP.0035346
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: