Basic Information
| Provider Information | |||||||||
| NPI: | 1457881211 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANNING | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KERNS | ||||||||
| OtherFirstName: | ELLEN | ||||||||
| OtherMiddleName: | K. | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8145 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454151703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373876395 | ||||||||
| FaxNumber: | 9373876557 | ||||||||
| Practice Location | |||||||||
| Address1: | 2611 WAYNE AVE | ||||||||
| Address2: | |||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372280579 | ||||||||
| FaxNumber: | 9376418517 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN293797 | OH | N | Nursing Service Providers | Registered Nurse | 163W00000X | RN.293797 | OH | Y | Nursing Service Providers | Registered Nurse |
No ID Information.