MEDICARE: TERRI LYNN SCHLARB 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	PN. 109645	OH

General Provider Information

NPI Number	:	1669609244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI LYNN SCHLARB LPN

Provider Business Mailing Address
First Line	:	3929 CENTER ST.
Second Line	:
City	:	NEW HAVEN
State	:	OH
Zip	:	44850
Country	:	US
Telephone Number	:	419-964-0590
Fax Number	:

Provider Business Practice Location Address
First Line	:	3929 CENTER STREET
Second Line	:
City	:	NEW HAVEN
State	:	OH
Zip	:	44850-0048
Country	:	US
Telephone Number	:	419-964-0590
Fax Number	:

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

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	06/22/2009

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