Provider Demographics
NPI:1740560473
Name:VONNA
Entity Type:Organization
Organization Name:VONNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STNA
Authorized Official - Prefix:
Authorized Official - First Name:VONNA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-268-8500
Mailing Address - Street 1:607 WHITMORE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1236
Mailing Address - Country:US
Mailing Address - Phone:937-268-8500
Mailing Address - Fax:
Practice Address - Street 1:607 WHITMORE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-1236
Practice Address - Country:US
Practice Address - Phone:937-268-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3793963303013140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric