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General NPI Number Information
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NPI Number | 1124517974
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Entity Type | Individual
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Provider Name | DESIREE PATRICIA SZABO LPN
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Gender | Female
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 7470 MANOR DR
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City | MENTOR ON THE LAKE
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State | OH
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Zip | 44060-3323
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Country | US
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Telephone | 440-278-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 7470 MANOR DR
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City | MENTOR ON THE LAKE
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State | OH
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Zip | 44060-3323
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Country | US
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Telephone | 440-278-0117
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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 | LPN.143060.MEDS-IV
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License Number State | OH
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