Individual
MRS. BROOKS A BAMBIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4388 WRIGHT RD., LAURA, OH 45337
(937) 248-4721
Mailing address
4388 WRIGHT RD., LAURA, OH 45337
(937) 248-4721
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
517867
OH
164W00000X
Licensed Practical Nurse
PN084533
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2090900
—
OH
Enumeration date
07/11/2005
Last updated
01/12/2023
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