Provider Demographics
NPI:1740798032
Name:LOGAN-GILBERT, DAYSHANA LASHAY (LPN)
Entity Type:Individual
Prefix:
First Name:DAYSHANA
Middle Name:LASHAY
Last Name:LOGAN-GILBERT
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 1:1463 HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44301-2110
Mailing Address - Country:US
Mailing Address - Phone:330-808-3992
Mailing Address - Fax:
Practice Address - Street 1:1463 HOLLY AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44301-2110
Practice Address - Country:US
Practice Address - Phone:330-808-3992
Practice Address - Fax:330-808-3992
Is Sole Proprietor?:No
Enumeration Date:2018-01-20
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.152988164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse