Provider Demographics
NPI:1598528861
Name:MAYNARD, ALAINA LYNN (STNA)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:LYNN
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 E MAIN ST LOT 57
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-9076
Mailing Address - Country:US
Mailing Address - Phone:513-223-0082
Mailing Address - Fax:
Practice Address - Street 1:12400 FITE RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:OH
Practice Address - Zip Code:45106-8639
Practice Address - Country:US
Practice Address - Phone:937-444-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH602658100523376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide