Provider Demographics
NPI:1972785772
Name:RHINEHART, LETITIA KAY (LPN)
Entity Type:Individual
Prefix:MS
First Name:LETITIA
Middle Name:KAY
Last Name:RHINEHART
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 1:10629 DOWLER RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWMARSHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44567
Mailing Address - Country:US
Mailing Address - Phone:614-271-7973
Mailing Address - Fax:
Practice Address - Street 1:10629 DOWLER RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NEWMARSHFIELD
Practice Address - State:OH
Practice Address - Zip Code:45667
Practice Address - Country:US
Practice Address - Phone:614-271-7973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN124566164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2708663Medicaid