Provider Demographics
NPI:1568114577
Name:MAYFIELD, TRICIA DAWN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TRICIA
Middle Name:DAWN
Last Name:MAYFIELD
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 1:3175 SHELLHART RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-5624
Mailing Address - Country:US
Mailing Address - Phone:330-351-5560
Mailing Address - Fax:
Practice Address - Street 1:3175 SHELLHART RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5624
Practice Address - Country:US
Practice Address - Phone:330-351-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146525164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse