Provider Demographics
NPI:1659573319
Name:LINES, BOBBI JO
Entity Type:Individual
Prefix:PROF
First Name:BOBBI
Middle Name:JO
Last Name:LINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4657
Mailing Address - Country:US
Mailing Address - Phone:740-387-4524
Mailing Address - Fax:
Practice Address - Street 1:374 CLINTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-4657
Practice Address - Country:US
Practice Address - Phone:740-494-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2074099374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide