Provider Demographics
NPI:1922401520
Name:ALBERT, DAVID CHARLES (LPN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:ALBERT
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-5307
Mailing Address - Country:US
Mailing Address - Phone:724-602-8866
Mailing Address - Fax:
Practice Address - Street 1:218 W COOPER ST
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1504
Practice Address - Country:US
Practice Address - Phone:724-602-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-27
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN251481L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse