Tina Gayle Etayem LPN

NPI 1013263896 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1013263896
Gender Female
Enumeration Date 07/30/2012
Last Updated 07/30/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
1736 HILLSIDE AVE
SPRINGFIELD OH, 45503-4508, US
Phone (937) 831-3874
Fax
Business Location
1736 HILLSIDE AVE
SPRINGFIELD OH, 45503-4508, US
Phone (937) 831-3874
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Ohio
License Number PN 074282 MEDS
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According to our database, Miss Tina Gayle Etayem LPN NPI is 1013263896, taxonomy code is 164W00000X and license number is PN 074282 MEDS, license state is located at Ohio. Tina Gayle Etayem LPN physically located at 1736 Hillside Ave, Springfield OH, 45503-4508. NPI Number Tina Gayle Etayem LPN has the Individual type.

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1013263896 NPI number is provided on an as is basis without warranty of any kind. 1013263896 is maintained by the National Plan & Provider Enumeration System. The contents of Tina Gayle Etayem LPN are for informational purposes only.