Provider Demographics
NPI:1770038606
Name:ROMBOUGH, LUCY LEONE (LPN)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:LEONE
Last Name:ROMBOUGH
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 1:20 GRAND VIEW LN
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-6252
Mailing Address - Country:US
Mailing Address - Phone:315-532-4515
Mailing Address - Fax:
Practice Address - Street 1:20 GRAND VIEW LN
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6252
Practice Address - Country:US
Practice Address - Phone:315-532-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY326298164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse