Provider Demographics
NPI:1437788536
Name:GARLAND, KATHY DIANE
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:DIANE
Last Name:GARLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-3335
Mailing Address - Country:US
Mailing Address - Phone:330-568-1407
Mailing Address - Fax:
Practice Address - Street 1:3805 LYNTZ TOWNLINE RD SW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-9213
Practice Address - Country:US
Practice Address - Phone:330-718-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.093151.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse