Basic Information
| Provider Information | |||||||||
| NPI: | 1437442100 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITMER | ||||||||
| FirstName: | JUNE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1049 DECKER DR | ||||||||
| Address2: | |||||||||
| City: | MIAMISBURG | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453426415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372084279 | ||||||||
| FaxNumber: | 9373418904 | ||||||||
| Practice Location | |||||||||
| Address1: | 10500 MONTGOMERY RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452424402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138651111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2011 | ||||||||
| LastUpdateDate: | 03/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN.176829-COA1 | OH | N | Nursing Service Providers | Registered Nurse | 364S00000X | COA09816-NS | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 364SA2200X | COA.09816-NS | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 0087529 | 05 | OH | MEDICAID |