Organization
GOLDEN YEARS NURSE PRACTITIONER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERIDAN R HULL NP (PRESIDENT)
(330) 389-1449
Entity
Organization
Contact information
Practice address
3107 LOVERS LN, RAVENNA, OH 44266-8930
(330) 389-1449
Mailing address
3107 LOVERS LN, RAVENNA, OH 44266-8930
(330) 389-1449
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2947744
—
OH
Enumeration date
04/01/2009
Last updated
04/04/2012
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