Most Relevant Information
Provider Data
| NPI Number: | 1003532078 |
| Provider Name: | TRACEY VANPETTEN RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 330922 |
Most Important Dates
| Enumeration Date: | 10/12/2022 |
| Last Updated: | 10/12/2022 |
Provider Practice Location
5945 WOODCREEK DR
MIDDLETOWN
OH
450423169
Practice Location Phone/Fax
| Phone: | 5135605396 |
| Fax: |
Provider Mailing Location
5945 WOODCREEK DR
MIDDLETOWN
OH
450423169
Provider Mailing Phone/Fax
| Phone: | 5135605396 |
| Fax: |