Individual
EDDA L ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
601 ROSAMOND DR, DAYTON, OH 45417-8839
(937) 530-3611
Mailing address
585 DAYTONA PKWY APT 2, DAYTON, OH 45406-2061
(937) 530-3611
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN461353
OH
164W00000X
Licensed Practical Nurse
071970
OH
Other
Enumeration date
03/19/2019
Last updated
03/29/2019
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