Individual
CONSTANCE MARIE VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
Mailing address
7142 CASTLECREST DR, HUBER HEIGHTS, OH 45424-3272
(937) 554-2238
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
020964
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN.CNP.020964
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0234408
—
OH
Enumeration date
06/07/2017
Last updated
11/17/2020
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