Provider Demographics
NPI:1124208509
Name:BIERMANN, MARYKA ANNE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:MARYKA
Middle Name:ANNE
Last Name:BIERMANN
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 1:12240 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:OH
Mailing Address - Zip Code:45341-9610
Mailing Address - Country:US
Mailing Address - Phone:937-878-8248
Mailing Address - Fax:
Practice Address - Street 1:12240 REVERE DR
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:OH
Practice Address - Zip Code:45341-9610
Practice Address - Country:US
Practice Address - Phone:937-878-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN035984164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse