MEDICARE: MS. DAYNA LYNN FROST 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	148911	OH

General Provider Information

NPI Number	:	1770836793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DAYNA LYNN FROST LPN

Provider Business Mailing Address
First Line	:	16115 JUDSON DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2157
Country	:	US
Telephone Number	:	216-702-8820
Fax Number	:

Provider Business Practice Location Address
First Line	:	16115 JUDSON DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2157
Country	:	US
Telephone Number	:	216-702-8820
Fax Number	:

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

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	10/16/2012

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