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1497303168
ANTHEA VYVIA MICKENS
YOUNGSTOWN, OH
NPI
1497303168
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OH 304090)
Enumeration Date
2019-08-27
Last Update Date
2019-08-27
Business Address
ANTHEA VYVIA MICKENS
1878 SELMA AVE
YOUNGSTOWN, OH 44504-1302
Phone number: 330-774-7551
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Mailing Address
ANTHEA VYVIA MICKENS
1878 SELMA AVE
YOUNGSTOWN, OH 44504-1302
Phone number: 330-774-7551
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