MEDICARE: CATHERINE ANN BARAN L.P.N.

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	PN089949	OH

General Provider Information

NPI Number	:	1831310291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE ANN BARAN L.P.N.

Provider Business Mailing Address
First Line	:	4377 VANDEMARK RD
Second Line	:
City	:	LITCHFIELD
State	:	OH
Zip	:	44253-9793
Country	:	US
Telephone Number	:	330-667-2124
Fax Number	:	330-667-2124

Provider Business Practice Location Address
First Line	:	4377 VANDEMARK RD
Second Line	:
City	:	LITCHFIELD
State	:	OH
Zip	:	44253-9793
Country	:	US
Telephone Number	:	330-667-2124
Fax Number	:	330-667-2124

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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