Provider Demographics
NPI:1629455688
Name:STROUD, DUANA MARNIKE (LPN)
Entity Type:Individual
Prefix:
First Name:DUANA
Middle Name:MARNIKE
Last Name:STROUD
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 1:1172 W GALBRAITH RD SUITE 202
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-6849
Mailing Address - Country:US
Mailing Address - Phone:513-200-9181
Mailing Address - Fax:
Practice Address - Street 1:1172 W GALBRAITH RD STE 202
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5643
Practice Address - Country:US
Practice Address - Phone:513-200-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 158076164W00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$OtherSSN