Individual
ANDREA BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
25 THORPE DR, DAYTON, OH 45420-1823
(937) 258-1446
Mailing address
25 THORPE DR, DAYTON, OH 45420-1823
(937) 457-2753
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN248405
OH
Other
Enumeration date
05/09/2019
Last updated
11/27/2023
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