Provider Demographics
NPI:1518116094
Name:SCHAUB, DENISE ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:ANN
Last Name:SCHAUB
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 1:703 S MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1621
Mailing Address - Country:US
Mailing Address - Phone:567-224-3133
Mailing Address - Fax:
Practice Address - Street 1:703 S MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1621
Practice Address - Country:US
Practice Address - Phone:567-224-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131385 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse