Provider Demographics
NPI:1538763735
Name:ISON, RHIANA SUMMER
Entity type:Individual
Prefix:
First Name:RHIANA
Middle Name:SUMMER
Last Name:ISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-2434
Mailing Address - Country:US
Mailing Address - Phone:937-270-4445
Mailing Address - Fax:
Practice Address - Street 1:6601 AUTUMN GLEN DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1479
Practice Address - Country:US
Practice Address - Phone:937-270-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant