Provider Demographics
NPI:1013229566
Name:ROUSH, LYNETTE M (MS, RN, ACNS-BC)
Entity Type:Individual
Prefix:MR
First Name:LYNETTE
Middle Name:M
Last Name:ROUSH
Suffix:
Gender:F
Credentials:MS, RN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3539 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9360
Mailing Address - Country:US
Mailing Address - Phone:614-527-1375
Mailing Address - Fax:
Practice Address - Street 1:3539 PINE RIDGE DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-9360
Practice Address - Country:US
Practice Address - Phone:614-527-1375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-278780163WM0705X
OHNS-10477 CNS163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical