Individual
LILA ROSE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-2007
Mailing address
1 WYOMING ST FL 1, DAYTON, OH 45409-2722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.412779
OH
176B00000X
Midwife
Primary
APRN.CNM.019323
OH
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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