Provider Demographics
NPI:1598806796
Name:WILSON, RAMONA FAYE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RAMONA
Middle Name:FAYE
Last Name:WILSON
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 1:3617 MIDDLE PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:OH
Mailing Address - Zip Code:43162-9632
Mailing Address - Country:US
Mailing Address - Phone:614-879-8232
Mailing Address - Fax:
Practice Address - Street 1:3617 MIDDLE PIKE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:OH
Practice Address - Zip Code:43162-9632
Practice Address - Country:US
Practice Address - Phone:614-879-8232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN053979164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse