Individual
JASON CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 872-7100
(513) 872-7385
Mailing address
PO BOX 636256, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
340675
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.15571.NA
OH
Other
Enumeration date
11/04/2013
Last updated
05/30/2017
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