Provider Demographics
NPI:1437234028
Name:CHECKAWITZ, MARTHA P (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:P
Last Name:CHECKAWITZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:MARTHA
Other - Middle Name:P
Other - Last Name:CHECKAWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:2549 MONTBELLO CIR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440-2352
Mailing Address - Country:US
Mailing Address - Phone:937-438-4636
Mailing Address - Fax:
Practice Address - Street 1:2549 MONTBELLO CIR
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440-2352
Practice Address - Country:US
Practice Address - Phone:937-438-4636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 042357164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse