Provider Demographics
NPI:1801128244
Name:MCINTOSH WEBB, MINDY MICHELLE (LPN-IV)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:MICHELLE
Last Name:MCINTOSH WEBB
Suffix:
Gender:F
Credentials:LPN-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-9597
Mailing Address - Country:US
Mailing Address - Phone:513-988-2468
Mailing Address - Fax:
Practice Address - Street 1:138 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-9597
Practice Address - Country:US
Practice Address - Phone:513-988-2468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH126847164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse