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Individual

DANIEL EDUARDO BEJARANO PUENTES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
823 MICHIGAN ST, SIDNEY, OH 45365-2685
(937) 498-5334
(937) 494-5914
Mailing address
3712 RUNYON AVE, TROTWOOD, OH 45416-1341
(937) 278-5155

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.020979
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.020979
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0234227
OH
Enumeration date
06/09/2017
Last updated
12/16/2020
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