Provider Demographics
NPI:1942441308
Name:MALONE, ALESIA M (LPN)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:M
Last Name:MALONE
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 1:58 PRIVATE DRIVE 910
Mailing Address - Street 2:
Mailing Address - City:PEDRO
Mailing Address - State:OH
Mailing Address - Zip Code:45659-8506
Mailing Address - Country:US
Mailing Address - Phone:740-532-0329
Mailing Address - Fax:
Practice Address - Street 1:58 PRIVATE DRIVE 910
Practice Address - Street 2:
Practice Address - City:PEDRO
Practice Address - State:OH
Practice Address - Zip Code:45659-8506
Practice Address - Country:US
Practice Address - Phone:740-532-0329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse