Provider Demographics
NPI:1295000669
Name:YEAGLE, LUCINDA GAIL (LPN)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:GAIL
Last Name:YEAGLE
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 1:1924 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:45369-9738
Mailing Address - Country:US
Mailing Address - Phone:937-631-4295
Mailing Address - Fax:
Practice Address - Street 1:1924 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SOUTH VIENNA
Practice Address - State:OH
Practice Address - Zip Code:45369-9738
Practice Address - Country:US
Practice Address - Phone:937-631-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-17
Last Update Date:2012-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.137647-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse