Provider Demographics
NPI:1922194414
Name:POSEDLY, LENORE RUTH (CNP)
Entity Type:Individual
Prefix:MS
First Name:LENORE
Middle Name:RUTH
Last Name:POSEDLY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MISS
Other - First Name:LENORE
Other - Middle Name:RUTRH
Other - Last Name:MANTIFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:1180 W GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-7519
Mailing Address - Country:US
Mailing Address - Phone:330-541-6779
Mailing Address - Fax:330-562-8755
Practice Address - Street 1:14121 PARKE LONG CT
Practice Address - Street 2:SUITE 201
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1647
Practice Address - Country:US
Practice Address - Phone:571-512-7287
Practice Address - Fax:800-752-2471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA110972261QA1903X
OHNP02818363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical