Healthcare Provider Details

I. General information

NPI: 1659707511
Provider Name (Legal Business Name): LENDY ANN CAUDILL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1389 COOK RD
LUCASVILLE OH
45648-8536
US

IV. Provider business mailing address

1389 COOK RD
LUCASVILLE OH
45648-8536
US

V. Phone/Fax

Practice location:
  • Phone: 740-285-2327
  • Fax:
Mailing address:
  • Phone: 740-285-2327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN142272MIV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: