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General NPI Number Information
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NPI Number | 1245009323
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Entity Type | Organization
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Legal Business Name | FUNNER MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 4720 STRATHAVEN DR
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City | DAYTON
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State | OH
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Zip | 45424-4662
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Country | US
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Telephone | 937-305-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 STRATHAVEN DR
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City | DAYTON
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State | OH
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Zip | 45424-4662
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Country | US
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Telephone | 937-234-7789
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Fax | 937-442-5574
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Authorized Official
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Title or Position | OWNER
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Name | KRISTYN FUNNER
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Credential | APRN
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Telephone | 937-234-7789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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