Provider Demographics
NPI:1821300997
Name:WORKMAN, LARRY (LPN)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9933 STATE ROUTE 700
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:OH
Mailing Address - Zip Code:44255-9730
Mailing Address - Country:US
Mailing Address - Phone:216-246-1325
Mailing Address - Fax:
Practice Address - Street 1:9933 STATE ROUTE 700
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:OH
Practice Address - Zip Code:44255-9730
Practice Address - Country:US
Practice Address - Phone:216-246-1325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.127167-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse