Provider Demographics
NPI:1003066895
Name:DENNISON, CATHY SUE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:SUE
Last Name:DENNISON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-1131
Mailing Address - Country:US
Mailing Address - Phone:740-380-0338
Mailing Address - Fax:
Practice Address - Street 1:884 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-1131
Practice Address - Country:US
Practice Address - Phone:740-380-0338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.095428164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse