Most Relevant Information
Provider Data
NPI Number: | 1003281858 |
Provider Name: | MALLORY MICHELLE MICHNA NP-C |
Entity Type: | Individual |
Taxonomy Code: | 363LF0000X |
Specialty: | Nurse Practitioner |
License Number: | COA.18458-NP |
Most Important Dates
Enumeration Date: | 12/04/2015 |
Last Updated: | 07/16/2024 |
Provider Practice Location
2960 FERNDOWN DR
MIAMISBURG
OH
453423585
Practice Location Phone/Fax
Phone: | 9378865510 |
Fax: | 9378132637 |
Provider Mailing Location
2960 FERNDOWN DR
MIAMISBURG
OH
453423585
Provider Mailing Phone/Fax
Phone: | 9378865510 |
Fax: | 9378132637 |