Individual
AUNDRYEA HARLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
373 N 11TH ST, NEWARK, OH 43055-4421
(740) 281-0908
Mailing address
373 N 11TH ST, NEWARK, OH 43055-4421
(740) 281-0908
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN. 128276
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2958081
—
OH
Enumeration date
09/04/2014
Last updated
09/04/2014
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