Provider Demographics
NPI:1366634073
Name:ISON, ANNA BARBARA (LPN)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:BARBARA
Last Name:ISON
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 1:1290 BOBO RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:OH
Mailing Address - Zip Code:45613
Mailing Address - Country:US
Mailing Address - Phone:740-289-3739
Mailing Address - Fax:
Practice Address - Street 1:1290 BOBO RD
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:OH
Practice Address - Zip Code:45613-9407
Practice Address - Country:US
Practice Address - Phone:740-289-3739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 096813164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse