Provider Demographics
NPI:1164616827
Name:KINTON, AJA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:AJA
Middle Name:LYNN
Last Name:KINTON
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 1:103 PARKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3217
Mailing Address - Country:US
Mailing Address - Phone:614-506-2969
Mailing Address - Fax:
Practice Address - Street 1:103 PARKWOOD BOULEVARD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3217
Practice Address - Country:US
Practice Address - Phone:614-506-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN108781164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse