Provider Demographics
NPI:1437893419
Name:DEAN, MARIE KATHERINE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:KATHERINE
Last Name:DEAN
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 1:1571 ANDREA DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3505
Mailing Address - Country:US
Mailing Address - Phone:216-548-7627
Mailing Address - Fax:
Practice Address - Street 1:1571 ANDREA DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3505
Practice Address - Country:US
Practice Address - Phone:216-548-7627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN-107040.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse