Provider Demographics
NPI:1881645885
Name:FLOYD, VERONICA L (LPN)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:L
Last Name:FLOYD
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 1:225 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4501
Mailing Address - Country:US
Mailing Address - Phone:740-808-2264
Mailing Address - Fax:
Practice Address - Street 1:855 ARIES DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1895
Practice Address - Country:US
Practice Address - Phone:614-775-9012
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-090556164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2209194Medicaid