Provider Demographics
NPI:1942646021
Name:WANKE, DEBBIE DENEE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:DENEE
Last Name:WANKE
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 1:567 MEADOWLANE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1943
Mailing Address - Country:US
Mailing Address - Phone:440-461-5005
Mailing Address - Fax:
Practice Address - Street 1:567 MEADOWLANE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1943
Practice Address - Country:US
Practice Address - Phone:440-461-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN146885164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse