Provider Demographics
NPI:1346309895
Name:SOMERS, DEBBIE LEE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:DEBBIE
Middle Name:LEE
Last Name:SOMERS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1318 MANFELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227
Mailing Address - Country:US
Mailing Address - Phone:740-877-2556
Mailing Address - Fax:
Practice Address - Street 1:1318 MANFELD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-2173
Practice Address - Country:US
Practice Address - Phone:740-877-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN090032164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2174258Medicaid