Provider Demographics
NPI:1851079891
Name:O'BANNON, FAITH (LPN)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:O'BANNON
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 1:1721 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-3515
Mailing Address - Country:US
Mailing Address - Phone:678-857-0228
Mailing Address - Fax:
Practice Address - Street 1:1721 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-3515
Practice Address - Country:US
Practice Address - Phone:678-857-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH142178164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse