Provider Demographics
NPI:1952370470
Name:CASE, LAUREEN K (LPN)
Entity Type:Individual
Prefix:MS
First Name:LAUREEN
Middle Name:K
Last Name:CASE
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 1:2142 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4829
Mailing Address - Country:US
Mailing Address - Phone:440-992-6916
Mailing Address - Fax:
Practice Address - Street 1:2142 W CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4829
Practice Address - Country:US
Practice Address - Phone:440-992-6916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN107114164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2357220Medicaid