Tracey Elaine Logan LPN

NPI 1073870267 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1073870267
Gender Female
Enumeration Date 04/12/2012
Last Updated 04/12/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
4466 SEMINARY ST
WAKEMAN OH, 44889-9208, US
Phone (567) 351-6317
Fax
Business Location
4466 SEMINARY ST
WAKEMAN OH, 44889-9208, US
Phone (567) 351-6317
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Ohio
License Number PN109065-M-IV
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According to our database, Mrs. Tracey Elaine Logan LPN NPI is 1073870267, taxonomy code is 164W00000X and license number is PN109065-M-IV, license state is located at Ohio. Tracey Elaine Logan LPN physically located at 4466 Seminary St, Wakeman OH, 44889-9208. NPI Number Tracey Elaine Logan LPN has the Individual type.

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1073870267 NPI number is provided on an as is basis without warranty of any kind. 1073870267 is maintained by the National Plan & Provider Enumeration System. The contents of Tracey Elaine Logan LPN are for informational purposes only.