Provider Demographics
NPI:1083953111
Name:VERNATTER, BELINDA SUE
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:SUE
Last Name:VERNATTER
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 1:1 WOODMOSS DR APT 3A
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-6433
Mailing Address - Country:US
Mailing Address - Phone:513-628-2264
Mailing Address - Fax:
Practice Address - Street 1:13 PROVIDENCE DR APT 178
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7555
Practice Address - Country:US
Practice Address - Phone:513-568-3918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-08
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH133613164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse