Provider Demographics
NPI:1619490729
Name:MCVAY, DELLA JOYCE (LPN)
Entity Type:Individual
Prefix:
First Name:DELLA
Middle Name:JOYCE
Last Name:MCVAY
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 1:3928 BURNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1327
Mailing Address - Country:US
Mailing Address - Phone:419-297-1450
Mailing Address - Fax:
Practice Address - Street 1:3928 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1327
Practice Address - Country:US
Practice Address - Phone:419-297-1450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH110470164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse