Provider Demographics
NPI:1164768917
Name:GERMANN, COLETTE ELAINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:ELAINE
Last Name:GERMANN
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 1:695 SATINWOOD N CR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903
Mailing Address - Country:US
Mailing Address - Phone:419-564-9922
Mailing Address - Fax:
Practice Address - Street 1:695 SATINWOOD N CR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903
Practice Address - Country:US
Practice Address - Phone:419-564-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137475-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPN.137475-M-IVOtherLICENSED PRACTICAL NURSE