Healthcare Provider Details

I. General information

NPI: 1205343936
Provider Name (Legal Business Name): ARREY I EYONGHEROK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2773 ORCHARD RUN RD
WEST CARROLLTON OH
45449-2831
US

IV. Provider business mailing address

3067 CHAMBERLIN DR
DAYTON OH
45449-3742
US

V. Phone/Fax

Practice location:
  • Phone: 937-734-8333
  • Fax:
Mailing address:
  • Phone: 937-329-7978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP.CNP.021963
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP.CNP.021963
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: