Provider Demographics
NPI:1255512414
Name:SCHLATTER, ANN M (LPN)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:SCHLATTER
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 1:930 29TH ST LOT 13
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2252
Mailing Address - Country:US
Mailing Address - Phone:740-353-1035
Mailing Address - Fax:
Practice Address - Street 1:930 29TH ST LOT 13
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2252
Practice Address - Country:US
Practice Address - Phone:740-353-1035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.109252164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2366345Medicaid