Healthcare Provider Details

I. General information

NPI: 1962645556
Provider Name (Legal Business Name): SANDY S CURTIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2009
Last Update Date: 04/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3377 SULPHUR SPRING RD
KINGSTON OH
45644-9705
US

IV. Provider business mailing address

3377 SULPHUR SPRING RD
KINGSTON OH
45644-9705
US

V. Phone/Fax

Practice location:
  • Phone: 740-466-2947
  • Fax:
Mailing address:
  • Phone: 740-466-2947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN.345468
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.102896
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: