Provider Demographics
NPI:1033434634
Name:ROMELL, RENEE MICHELE (LPN)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MICHELE
Last Name:ROMELL
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 1:5912 SR 113 E.
Mailing Address - Street 2:
Mailing Address - City:BERLIN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44814
Mailing Address - Country:US
Mailing Address - Phone:419-541-1260
Mailing Address - Fax:
Practice Address - Street 1:5912 STATE ROUTE 113 E
Practice Address - Street 2:
Practice Address - City:BERLIN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44814-9522
Practice Address - Country:US
Practice Address - Phone:419-541-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH113351164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse