MEDICARE: VICTORIA LYNN DELL LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	2015007283	MO

General Provider Information

NPI Number	:	1730042078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA LYNN DELL LPN

Provider Business Mailing Address
First Line	:	3065 WOBURN DR
Second Line	:
City	:	COVENTRY TOWNSHIP
State	:	OH
Zip	:	44319-1717
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3065 WOBURN DR
Second Line	:
City	:	COVENTRY TOWNSHIP
State	:	OH
Zip	:	44319-1717
Country	:	US
Telephone Number	:	234-376-3132
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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