Provider Demographics
NPI:1770214363
Name:RABNE, LYDIA ROSE (LPN)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:ROSE
Last Name:RABNE
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 1:10333 PINE NEEDLE TRL
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-1285
Mailing Address - Country:US
Mailing Address - Phone:440-732-6050
Mailing Address - Fax:
Practice Address - Street 1:10333 PINE NEEDLE TRL
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-1285
Practice Address - Country:US
Practice Address - Phone:440-732-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.182331.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse