Provider Demographics
NPI:1164739439
Name:LYKINS, REBECCA JOCIE (LPN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOCIE
Last Name:LYKINS
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 1:480 HANNA RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-6004
Mailing Address - Country:US
Mailing Address - Phone:419-566-2989
Mailing Address - Fax:
Practice Address - Street 1:480 HANNA RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-6004
Practice Address - Country:US
Practice Address - Phone:419-566-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137636-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse