Healthcare Provider Details

I. General information

NPI: 1750809133
Provider Name (Legal Business Name): AMY MARIE MUSAY LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY MARIE KAUFFMAN LPN

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S WOOSTER AVE
DOVER OH
44622-1944
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.114379.MEDS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: