Individual
TINA S LEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
16501 SQUARE DR, MARYSVILLE, OH 43040-9557
(937) 738-6999
Mailing address
16501 SQUARE DR, MARYSVILLE, OH 43040-9557
(937) 738-6999
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN359667
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-3753384
—
OH
Enumeration date
07/24/2018
Last updated
07/24/2018
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