Individual
ELYSSA LYNN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2195 ALLENTOWN RD, LIMA, OH 45805-1705
(419) 227-2245
Mailing address
18906 BEBB ST, VENEDOCIA, OH 45894-9646
(567) 644-5847
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN.463288
OH
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.0033090
OH
Other
Enumeration date
01/19/2023
Last updated
01/25/2023
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