Provider Demographics
NPI:1225485865
Name:FOY, THERESA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:FOY
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 1:40 HELEN AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-1905
Mailing Address - Country:US
Mailing Address - Phone:330-651-8966
Mailing Address - Fax:
Practice Address - Street 1:40 HELEN AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-1905
Practice Address - Country:US
Practice Address - Phone:330-651-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.136075-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse