Individual
MRS. ANNETTE VAN DAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
21 E. STATE ST. OFFICE 233 COLUMBUS, OH 43215, OFFIXE 233, COLUMBUS, OH 43215
(888) 731-8994
(623) 999-1761
Mailing address
796 NINEVAH RD, FRANKFORT, KY 40601-7960
(888) 731-8994
(833) 755-1861
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
3009783
KY
207QA0505X
Adult Medicine Physician
Primary
3009783
KY
208D00000X
General Practice Physician
3009783
KY
363L00000X
Nurse Practitioner
3009783
KY
363LF0000X
Family Nurse Practitioner
3009783
KY
Other
Enumeration date
10/20/2015
Last updated
04/23/2026
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