Individual
BROOKE SHIVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4560 STATE ROUTE 222, BATAVIA, OH 45103-9778
(513) 732-1601
Mailing address
105 SPRING ST APT 3, BETHEL, OH 45106-1420
(513) 391-0124
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
117706
OH
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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