Individual
BARBARA HANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 SOUTHERN BLVD, 1 EAST, KETTERING, OH 45429-1221
(937) 395-8248
(937) 395-8358
Mailing address
3535 SOUTHERN BLVD, 1 EAST, KETTERING, OH 45429-1221
(937) 395-8248
(937) 395-8358
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN270584
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
COA16908NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117226
—
OH
Enumeration date
12/16/2014
Last updated
01/25/2021
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