Individual
TERESA MUSTOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
2222 PHILADELPHIA DR, SUITE 4505, DAYTON, OH 45406-1813
(937) 434-4363
(937) 734-4181
Mailing address
2222 PHILADELPHIA DR, SUITE 4505, DAYTON, OH 45406-1813
(937) 434-4363
(937) 734-4181
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
COA11184NS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3090346
—
OH
Enumeration date
06/02/2010
Last updated
12/18/2013
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