Provider Demographics
NPI:1518181312
Name:SCHREIBER, GERRY LYNNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:GERRY
Middle Name:LYNNE
Last Name:SCHREIBER
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 1:4351 STATE ROUTE 84
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44048-9750
Mailing Address - Country:US
Mailing Address - Phone:440-224-1208
Mailing Address - Fax:
Practice Address - Street 1:4351 STATE ROUTE 84
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44048-9750
Practice Address - Country:US
Practice Address - Phone:440-224-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 068220164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2473407Medicaid