Provider Demographics
NPI:1508079104
Name:ROBERTS, VALENA SACHEEN (LPN)
Entity Type:Individual
Prefix:
First Name:VALENA
Middle Name:SACHEEN
Last Name:ROBERTS
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 1:856 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-9427
Mailing Address - Country:US
Mailing Address - Phone:740-835-7887
Mailing Address - Fax:
Practice Address - Street 1:856 HOWARD RD
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9427
Practice Address - Country:US
Practice Address - Phone:740-835-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN116953-IV164W00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376J00000XNursing Service Related ProvidersHomemaker