Provider Demographics
NPI:1114280617
Name:DEWEES, ELIZABETH ANSLI (LPN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANSLI
Last Name:DEWEES
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 1:9315 LINCOLN DR
Mailing Address - Street 2:APT. C 10
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-4145
Mailing Address - Country:US
Mailing Address - Phone:216-952-2889
Mailing Address - Fax:330-748-4957
Practice Address - Street 1:9315 LINCOLN DR
Practice Address - Street 2:APT. C 10
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-4145
Practice Address - Country:US
Practice Address - Phone:216-952-2889
Practice Address - Fax:330-748-4957
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH117250164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse