Provider Demographics
NPI:1659707511
Name:CAUDILL, LENDY ANN (LPN)
Entity Type:Individual
Prefix:
First Name:LENDY
Middle Name:ANN
Last Name:CAUDILL
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 1:1389 COOK RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648-8536
Mailing Address - Country:US
Mailing Address - Phone:740-285-2327
Mailing Address - Fax:
Practice Address - Street 1:1389 COOK RD
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45648-8536
Practice Address - Country:US
Practice Address - Phone:740-285-2327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN142272MIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse