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Individual

CODEE MASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
4457 STATE ROUTE 159, CHILLICOTHE, OH 45601-8620
(740) 779-7813
Mailing address
272 HOSPITAL RD, CHILLICOTHE, OH 45601-9031
(740) 779-7500
(740) 779-4257

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.024960
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0373072
OH
Enumeration date
09/06/2019
Last updated
12/21/2020
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