Individual
MRS. BERTHA RENEE KIRWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, MSN
Contact information
Practice address
332 CONGRESS PARK DR, DAYTON, OH 45459-4133
(937) 312-3627
Mailing address
6845 WORTHINGTON GALENA RD, WORTHINGTON, OH 43085-2645
(614) 847-3891
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12637
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12637
BOARD OF NURSING, COA
OH
01
—
313697
RN LICENSE
OH
Enumeration date
09/22/2011
Last updated
09/22/2011
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