Healthcare Provider Details

I. General information

NPI: 1073972733
Provider Name (Legal Business Name): CATHY VANCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 N FAIR AVE
HAMILTON OH
45011-4242
US

IV. Provider business mailing address

281 NORTH FAIR AVE
HAMILTON OH
45011
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-5610
  • Fax:
Mailing address:
  • Phone: 513-868-5610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number299654
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: