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General NPI Number Information
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NPI Number | 1972808848
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Entity Type | Organization
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Legal Business Name | DUNAMIS AUXANO LLC
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 121 W MAIN ST
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City | LOUDONVILLE
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State | OH
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Zip | 44842-1247
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Country | US
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Telephone | 419-994-0212
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Fax | 419-994-0215
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Provider Business Mailing Address
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Address Line | 121 W MAIN ST
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City | LOUDONVILLE
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State | OH
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Zip | 44842-1247
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Country | US
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Telephone | 419-994-0212
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Fax | 419-994-0215
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. DANIELE C. MARSH
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Credential | N.P.
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Telephone | 740-507-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | COA11616-NP
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License Number State | OH
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