Provider Demographics
NPI:1265782270
Name:KALTENBACH, CAROL S (LPN)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:S
Last Name:KALTENBACH
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 1:15397 BEAR CREEK CT
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8690
Mailing Address - Country:US
Mailing Address - Phone:419-494-7062
Mailing Address - Fax:
Practice Address - Street 1:15397 BEAR CREEK CT
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8690
Practice Address - Country:US
Practice Address - Phone:419-494-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH069367164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse