Provider Demographics
NPI:1952841744
Name:VOLAND, REBECCA M (LPN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:VOLAND
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 1:3976 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4851
Mailing Address - Country:US
Mailing Address - Phone:216-952-7099
Mailing Address - Fax:
Practice Address - Street 1:3976 E 54TH ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-4851
Practice Address - Country:US
Practice Address - Phone:216-952-7099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 121576 MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse