Individual
JACQUELINE DELAINE ADRIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 SOUTHERN BLVD STE 2100, KETTERING, OH 45429-1221
(937) 395-8556
(937) 395-6376
Mailing address
3533 SOUTHERN BLVD STE 2100, KETTERING, OH 45429-1267
(937) 395-8556
(937) 395-6376
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNOP.024796
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRNCNP024796
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0362039
—
OH
Enumeration date
06/13/2019
Last updated
11/12/2024
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