Provider Demographics
NPI:1467706002
Name:FURYES, RENEE E (LPN)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:E
Last Name:FURYES
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 1:26639 LAKE OF THE FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-2608
Mailing Address - Country:US
Mailing Address - Phone:440-610-7538
Mailing Address - Fax:
Practice Address - Street 1:26639 LAKE OF THE FALLS BLVD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-2608
Practice Address - Country:US
Practice Address - Phone:440-610-7538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH147616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH147616OtherOHIO BOAD OF NURSING