Shawn Brodess
Registered Nurse, Critical Care Medicine in Dayton, OH. Individual provider (NPI-1).
NPI number1104547934
StatusActive
Last updated in NPPESSep 9, 2022
Details
- NPI
- 1104547934
- Entity type
- Individual (NPI-1)
- Name
- Shawn Brodess
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 9, 2022
- Certification date
- Sep 9, 2022
- Last updated
- Sep 9, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WC0200X | Registered Nurse, Critical Care Medicine | 381510 | OH | Yes |
| 163WG0000X | Registered Nurse, General Practice | 381510 | OH |
Practice location
4100 W 3rd StDayton, OH 45428-9000
Phone 937-268-6511
Mailing address
1138 S Main StWest Milton, OH 45383-1342
Phone 937-418-3301
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