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Individual

SANDRA K MENKEDICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 475-8690
(513) 475-7257
Mailing address
231 ALBERT SABIN WAY, CINCINNATI, OH 45267-2827
(859) 426-4051

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
06618
OH
363L00000X
Nurse Practitioner
3591P
KY
363L00000X
Nurse Practitioner
Primary
APRNCNP06618
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2364365
OH
Enumeration date
04/21/2006
Last updated
02/19/2018
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