Healthcare Provider Details

I. General information

NPI: 1659199958
Provider Name (Legal Business Name): AUBREY V DYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AUBREY V HOSSFELD

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 EVANS RD
WEST PORTSMOUTH OH
45663-8918
US

IV. Provider business mailing address

20 VAUGHTERS RUN RD
WEST PORTSMOUTH OH
45663-8600
US

V. Phone/Fax

Practice location:
  • Phone: 740-727-2945
  • Fax:
Mailing address:
  • Phone: 740-727-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.187116
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: