Provider Demographics
NPI:1083990618
Name:VANGELDER, TAMELA LEE (LPN)
Entity Type:Individual
Prefix:
First Name:TAMELA
Middle Name:LEE
Last Name:VANGELDER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:TAMELA
Other - Middle Name:
Other - Last Name:WILKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:446 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2348
Mailing Address - Country:US
Mailing Address - Phone:513-834-7063
Mailing Address - Fax:513-873-1567
Practice Address - Street 1:8120 GARNET DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458
Practice Address - Country:US
Practice Address - Phone:138-347-0635
Practice Address - Fax:513-873-1567
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN167265164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse