Individual
FANTA BERETAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5783 DAFFODIL CT, GROVE CITY, OH 43123-9456
(614) 991-4895
(614) 991-4895
Mailing address
5783 DAFFODIL CT, GROVE CITY, OH 43123-9456
(614) 493-9884
(614) 991-4895
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRNCNP020429
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.020429
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.020429
OH
Other
Enumeration date
09/16/2008
Last updated
06/28/2023
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