Provider Demographics
NPI:1003513854
Name:DIALS, WYNONA HILL
Entity Type:Individual
Prefix:
First Name:WYNONA
Middle Name:HILL
Last Name:DIALS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 NICHOLE CT
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-6702
Mailing Address - Country:US
Mailing Address - Phone:480-621-2325
Mailing Address - Fax:
Practice Address - Street 1:47 NICHOLE CT
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-6702
Practice Address - Country:US
Practice Address - Phone:480-251-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH37400000XMedicaid