NPI 1013263896

Tina Gayle Etayem, LPN

Practitioner Licensed Practical Nurse Springfield, OH

Practice location

Address: 1736 Hillside Ave, Springfield, OH 45503-4508
Phone: (937) 831-3874

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence PN 074282 MEDS (OH)

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Registry record

NPI: 1013263896
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jul 2012
Record last updated: 30 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.