Provider Demographics
NPI:1760882039
Name:MEH, PRODENCIA
Entity Type:Individual
Prefix:
First Name:PRODENCIA
Middle Name:
Last Name:MEH
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 1:8061 VICTORY GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9061
Mailing Address - Country:US
Mailing Address - Phone:513-237-3433
Mailing Address - Fax:
Practice Address - Street 1:8061 VICTORY GARDEN LN
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-9061
Practice Address - Country:US
Practice Address - Phone:513-237-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH330327163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse