Provider Demographics
NPI:1407149289
Name:DUDDING, GENNA (LPN)
Entity Type:Individual
Prefix:
First Name:GENNA
Middle Name:
Last Name:DUDDING
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 1:850 S SPRING RD
Mailing Address - Street 2:
Mailing Address - City:WETERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081
Mailing Address - Country:US
Mailing Address - Phone:614-592-0309
Mailing Address - Fax:
Practice Address - Street 1:850 S SPRING RD
Practice Address - Street 2:
Practice Address - City:WETERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081
Practice Address - Country:US
Practice Address - Phone:614-592-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 137984164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse