Provider Demographics
NPI:1346316379
Name:DUBECK, AARICA B (LPN)
Entity Type:Individual
Prefix:MS
First Name:AARICA
Middle Name:B
Last Name:DUBECK
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43723-0062
Mailing Address - Country:US
Mailing Address - Phone:740-685-2041
Mailing Address - Fax:
Practice Address - Street 1:120 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1324
Practice Address - Country:US
Practice Address - Phone:740-685-2041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 119907164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH104835140599Medicaid