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Individual

AMANDA DENISE LA FAVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10500 MONTGOMERY RD, CINCINNATI, OH 45242-4402
(513) 865-1111
Mailing address
1720 RED CLOVER DR, LEBANON, OH 45036-4094
(270) 585-3854

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
019993
OH

Other

Enumeration date
02/24/2020
Last updated
02/24/2020
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