Provider Demographics
NPI:1912231994
Name:DEAK, AIMEE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:LYNN
Last Name:DEAK
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 1:10060 CUTTS RD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9183
Mailing Address - Country:US
Mailing Address - Phone:440-286-2316
Mailing Address - Fax:440-286-2355
Practice Address - Street 1:10060 CUTTS RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9183
Practice Address - Country:US
Practice Address - Phone:440-286-2316
Practice Address - Fax:440-286-2355
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 109821 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse