Provider Demographics
NPI:1467695874
Name:FITCH, PAIGE T (LPN)
Entity Type:Individual
Prefix:MISS
First Name:PAIGE
Middle Name:T
Last Name:FITCH
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 1:23446 LETCHWORTH RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4106
Mailing Address - Country:US
Mailing Address - Phone:216-246-7525
Mailing Address - Fax:
Practice Address - Street 1:23446 LETCHWORTH RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4106
Practice Address - Country:US
Practice Address - Phone:216-246-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN126022-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse