Provider Demographics
NPI:1821328519
Name:PRITCHARD, MISSEY LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MISSEY
Middle Name:LYNN
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:MISSEY
Other - Middle Name:LYNN
Other - Last Name:PRITCHARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:904 W RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545-1347
Mailing Address - Country:US
Mailing Address - Phone:419-592-0405
Mailing Address - Fax:
Practice Address - Street 1:904 W RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-1347
Practice Address - Country:US
Practice Address - Phone:419-592-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-03
Last Update Date:2010-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.097420164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse