Individual
COURTNEY NICOLE KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S EDWIN C MOSES BLVD, DAYTON, OH 45417-3424
(937) 734-4310
Mailing address
601 S EDWIN C MOSES BLVD, DAYTON, OH 45417-3424
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.185425
OH
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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