Provider Demographics
NPI:1578763173
Name:REITZ-ABSHER, LUCINDA K (LPN)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:K
Last Name:REITZ-ABSHER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LUCINDA
Other - Middle Name:K
Other - Last Name:REITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:484 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-1314
Mailing Address - Country:US
Mailing Address - Phone:440-593-5579
Mailing Address - Fax:
Practice Address - Street 1:484 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-1314
Practice Address - Country:US
Practice Address - Phone:440-593-5579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN;.065639164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse