Individual
MADHAVI INTURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429
(937) 395-6665
(937) 395-6668
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.023133
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.023133
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0310901
—
OH
Enumeration date
07/23/2018
Last updated
10/04/2022
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