Provider Demographics
NPI:1063837615
Name:SCAVINSKI, LAURA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:SCAVINSKI
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 1:20270 ROYALTON RD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-4979
Mailing Address - Country:US
Mailing Address - Phone:440-268-5678
Mailing Address - Fax:
Practice Address - Street 1:20270 ROYALTON RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-4979
Practice Address - Country:US
Practice Address - Phone:440-268-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN106873164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse