Provider Demographics
NPI:1629385570
Name:KEMERY, LIZA EILEEN (LPN)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:EILEEN
Last Name:KEMERY
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 1:944 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-2743
Mailing Address - Country:US
Mailing Address - Phone:419-689-2974
Mailing Address - Fax:
Practice Address - Street 1:944 ROGERS ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2743
Practice Address - Country:US
Practice Address - Phone:419-689-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH130417164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse