Provider Demographics
NPI:1083766851
Name:LADBETTER, DENICE
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:
Last Name:LADBETTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5965 HARRISBURG GEORGESVILL RD LOT 244
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-9165
Mailing Address - Country:US
Mailing Address - Phone:614-305-4522
Mailing Address - Fax:
Practice Address - Street 1:810 BRADWELL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-4160
Practice Address - Country:US
Practice Address - Phone:614-491-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2570178374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide