Provider Demographics
NPI:1164275707
Name:RAMOS, DESTINY LEE
Entity Type:Individual
Prefix:
First Name:DESTINY
Middle Name:LEE
Last Name:RAMOS
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 1:404 N KEYSER ST
Mailing Address - Street 2:
Mailing Address - City:HOLGATE
Mailing Address - State:OH
Mailing Address - Zip Code:43527-9719
Mailing Address - Country:US
Mailing Address - Phone:567-376-7269
Mailing Address - Fax:
Practice Address - Street 1:245 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1064
Practice Address - Country:US
Practice Address - Phone:419-796-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant