Provider Demographics
NPI:1497273346
Name:RIDENOUR-ONEIL, WENDY R (LPN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:RIDENOUR-ONEIL
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 1:13220 DARROW RD
Mailing Address - Street 2:
Mailing Address - City:VERMILION
Mailing Address - State:OH
Mailing Address - Zip Code:44089-9516
Mailing Address - Country:US
Mailing Address - Phone:419-602-9560
Mailing Address - Fax:
Practice Address - Street 1:13220 DARROW RD
Practice Address - Street 2:
Practice Address - City:VERMILION
Practice Address - State:OH
Practice Address - Zip Code:44089-9516
Practice Address - Country:US
Practice Address - Phone:419-602-9560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH113960164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH113969OtherSTATE OF OHIO