Provider Demographics
NPI:1932349768
Name:MANN, ALEKSANDRA (LPN)
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:MANN
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 1:2708 REYNOLDSBURG NEW ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9500
Mailing Address - Country:US
Mailing Address - Phone:614-376-8185
Mailing Address - Fax:
Practice Address - Street 1:2708 REYNOLDSBURG NEW ALBANY RD
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-9500
Practice Address - Country:US
Practice Address - Phone:614-376-8185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH133970164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2824822Medicaid