Provider Demographics
NPI:1538519814
Name:ROMANCHENKO, LINA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:ROMANCHENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 W SCULLY DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-9200
Mailing Address - Country:US
Mailing Address - Phone:216-570-7399
Mailing Address - Fax:
Practice Address - Street 1:4754 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1002
Practice Address - Country:US
Practice Address - Phone:216-570-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide