KETTERING PHYSICIAN NETWORK NPI 1346791712

NPI Information

  • NPI: 1346791712
  • Provider Name: KETTERING PHYSICIAN NETWORK
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 36D2228035
  • Address: 3533 SOUTHERN BOULEVARD
    SUITE 5350
    KETTERING, OH
    ZIP 45429
  • Phone: (937) 643-9299

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NPI Details

KETTERING PHYSICIAN NETWORK is a family nurse practitioner in Kettering, OH. KETTERING PHYSICIAN NETWORK NPI is 1346791712. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3533 SOUTHERN BOULEVARD
SUITE 5350
KETTERING, OH
ZIP 45429
Phone: (937) 643-9299
Fax: (937) 643-2343

The provider's authorized official is Angela Marie Yost .
The authorized official title is Nurse Practitioner and has the following contact phone number (937) 643-9299.

The CLIA number assigned to this NPI record is 36D2228035 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/20/2016 and was last updated on 10/20/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAPRN.CNP 019661OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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