Individual
MR. JESSE WADE VANDYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
921 E FRANKLIN ST, KENTON, OH 43326-2020
(614) 566-8883
(614) 566-8149
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.024658
OH
Other
Enumeration date
08/17/2019
Last updated
06/28/2021
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