Provider Demographics
NPI:1679176721
Name:PRINGLE, ARLIANNA ROXANNE DELMINDO
Entity Type:Individual
Prefix:
First Name:ARLIANNA
Middle Name:ROXANNE DELMINDO
Last Name:PRINGLE
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 1:157 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-8353
Mailing Address - Country:US
Mailing Address - Phone:614-584-3026
Mailing Address - Fax:
Practice Address - Street 1:272 ESSEX PL
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7561
Practice Address - Country:US
Practice Address - Phone:614-584-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3124934Medicaid