Provider Demographics
NPI:1326417338
Name:VINCENT-LANUM, YVONNE KARIN (LPN)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:KARIN
Last Name:VINCENT-LANUM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:KARIN
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:6478 ROYALTON RD REAR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-4924
Mailing Address - Country:US
Mailing Address - Phone:440-364-8767
Mailing Address - Fax:
Practice Address - Street 1:6478 ROYALTON RD REAR
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-4924
Practice Address - Country:US
Practice Address - Phone:440-364-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-20
Last Update Date:2015-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH144168164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse