Provider Demographics
NPI:1407670524
Name:DILLARD, CHARITY ANNETTE (REGISTERED NURSE)
Entity type:Individual
Prefix:MISS
First Name:CHARITY
Middle Name:ANNETTE
Last Name:DILLARD
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-2229
Mailing Address - Country:US
Mailing Address - Phone:513-914-8851
Mailing Address - Fax:
Practice Address - Street 1:1299 SPRINGFIELD DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2229
Practice Address - Country:US
Practice Address - Phone:513-914-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH437306163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health