Provider Demographics
NPI:1578845624
Name:MCCREARY, ALISHA N (LPN)
Entity Type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:N
Last Name:MCCREARY
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 1:2556 BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4615
Mailing Address - Country:US
Mailing Address - Phone:419-699-7207
Mailing Address - Fax:
Practice Address - Street 1:2556 BRIAR LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-4615
Practice Address - Country:US
Practice Address - Phone:419-699-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 128979164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse