Provider Demographics
NPI:1891930095
Name:DEDINO, JOYCE (RN)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:DEDINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12616 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:WAKEMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44889-9260
Mailing Address - Country:US
Mailing Address - Phone:440-965-4044
Mailing Address - Fax:
Practice Address - Street 1:12616 BUTLER RD
Practice Address - Street 2:
Practice Address - City:WAKEMAN
Practice Address - State:OH
Practice Address - Zip Code:44889-9260
Practice Address - Country:US
Practice Address - Phone:440-965-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN228411163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse