Provider Demographics
NPI:1407326614
Name:OHANNON, ARIEL LAUREN PATRICE (CNA)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:LAUREN PATRICE
Last Name:OHANNON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:LAUREN PATRICE
Other - Last Name:OHANNON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1925 E PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1517
Mailing Address - Country:US
Mailing Address - Phone:856-212-2384
Mailing Address - Fax:
Practice Address - Street 1:2122 E CHELTEN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2536
Practice Address - Country:US
Practice Address - Phone:856-212-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10056028376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide