Individual
MICHELLE LAVENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2041 FAIRPORT AVE, DAYTON, OH 45406-3416
(513) 501-6503
Mailing address
2041 FAIRPORT AVE, DAYTON, OH 45406-3416
(513) 501-6503
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
371943240204
OH
376K00000X
Nurse's Aide
Primary
371943240294
OH
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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