Healthcare Provider Details

I. General information

NPI: 1821936592
Provider Name (Legal Business Name): ELIZABETH FRANCES EAREHART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2066 W MAIN ST STE 130
XENIA OH
45385-2882
US

IV. Provider business mailing address

3170 KETTERING BLVD BLDG B2ND
MORAINE OH
45439-1924
US

V. Phone/Fax

Practice location:
  • Phone: 937-372-7583
  • Fax: 937-372-7727
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0041826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: