Individual
MRS. BEVERLY ANN WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
610 TALOWOOD DR, BEAVERCREEK, OH 45430-1619
(937) 427-9177
Mailing address
610 TALOWOOD DR, BEAVERCREEK, OH 45430-1619
(937) 427-9177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN, 119698
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2705139
—
OH
Enumeration date
03/22/2007
Last updated
07/09/2007
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