Provider Demographics
NPI:1508099771
Name:DILEONARDO, ANNETTE (LPN)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:DILEONARDO
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 1:3200 STATION RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7720
Mailing Address - Country:US
Mailing Address - Phone:330-241-5349
Mailing Address - Fax:
Practice Address - Street 1:3200 STATION RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7720
Practice Address - Country:US
Practice Address - Phone:330-241-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 122513 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse