Individual
KIMBERLY SUE MASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7695 POE AVE, DAYTON, OH 45414-2552
(937) 280-2000
Mailing address
7695 POE AVE, DAYTON, OH 45414-2552
(937) 280-2000
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN298052
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
09/25/2020
Last updated
09/25/2020
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