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General NPI Number Information
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NPI Number | 1740560473
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Entity Type | Organization
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Legal Business Name | VONNA
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 607 WHITMORE AVE
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City | DAYTON
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State | OH
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Zip | 45417-1236
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Country | US
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Telephone | 937-268-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 607 WHITMORE AVE
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City | DAYTON
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State | OH
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Zip | 45417-1236
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Country | US
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Telephone | 937-268-8500
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Fax |
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Authorized Official
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Title or Position | STNA
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Name | VONNA NICOLE HINTON
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Credential |
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Telephone | 937-268-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 379396330301
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License Number State | OH
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