Provider Demographics
NPI:1548599665
Name:BAYLOR, NOLISHA L (LPN)
Entity Type:Individual
Prefix:
First Name:NOLISHA
Middle Name:L
Last Name:BAYLOR
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 1:723 LILLY LANDING LN
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7052
Mailing Address - Country:US
Mailing Address - Phone:614-772-9932
Mailing Address - Fax:
Practice Address - Street 1:723 LILLY LANDING LN
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7052
Practice Address - Country:US
Practice Address - Phone:614-772-9932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-19
Last Update Date:2009-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN137792164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse