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General NPI Number Information
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NPI Number | 1104395292
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Entity Type | Individual
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Provider Name | BECKY JANE VLIEGE LPN
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Gender | Female
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 865 S PATTERSON BLVD
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City | DAYTON
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State | OH
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Zip | 45402-2624
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Country | US
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Telephone | 937-966-4673
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Fax | 513-873-1567
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Provider Business Mailing Address
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Address Line | 100 CROWNE POINT PL
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City | CINCINNATI
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State | OH
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Zip | 45241-5427
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Country | US
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Telephone | 513-743-7628
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 164193
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LPN.164193.MEDS-IV
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License Number State | OH
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