Provider Demographics
NPI:1578740346
Name:SANDLUND, LAYLA BLISS (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LAYLA
Middle Name:BLISS
Last Name:SANDLUND
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 1:4623 MILLENNIUM DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1194
Mailing Address - Country:US
Mailing Address - Phone:740-624-8180
Mailing Address - Fax:
Practice Address - Street 1:890 ORCHARD HILL RD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1363
Practice Address - Country:US
Practice Address - Phone:740-588-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 127298164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse