Provider Demographics
NPI:1275664294
Name:LAMBERT, CONNIE L (STNA)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:L
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8480 WAYNE TRACE RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45311-8731
Mailing Address - Country:US
Mailing Address - Phone:513-315-6158
Mailing Address - Fax:
Practice Address - Street 1:8480 WAYNE TRACE RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45311-8731
Practice Address - Country:US
Practice Address - Phone:513-315-6158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400299891103376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide