Provider Demographics
NPI:1417127051
Name:SLONE, BRANDY NICHOLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:NICHOLE
Last Name:SLONE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:BRANDY
Other - Middle Name:NICHOLE
Other - Last Name:BLANTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:4422 DININGER RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:OH
Mailing Address - Zip Code:44875-9554
Mailing Address - Country:US
Mailing Address - Phone:419-543-1793
Mailing Address - Fax:
Practice Address - Street 1:4422 DININGER RD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-9554
Practice Address - Country:US
Practice Address - Phone:419-543-1793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN116361164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse