Provider Demographics
NPI:1093039661
Name:WURSTER, HOWARD JOSEPH (LPN)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:JOSEPH
Last Name:WURSTER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 VITTMER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-2205
Mailing Address - Country:US
Mailing Address - Phone:513-344-7581
Mailing Address - Fax:513-842-8609
Practice Address - Street 1:3279 VITTMER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2205
Practice Address - Country:US
Practice Address - Phone:513-344-7581
Practice Address - Fax:513-842-8609
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 132631 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse