Healthcare Provider Details
I. General information
NPI: 1962283507
Provider Name (Legal Business Name): MONICA ROSE DENNISON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/10/2023
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50701 CRAWFORD RD
WOODSFIELD OH
43793-9230
US
IV. Provider business mailing address
50701 CRAWFORD RD
WOODSFIELD OH
43793-9230
US
V. Phone/Fax
- Phone: 174-062-1061
- Fax:
- Phone: 740-621-0613
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0200X |
| Taxonomy | Home Health Registered Nurse |
| License Number | 275017 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: