Provider Demographics
NPI:1952588261
Name:DEGARMO, CAROLYN JONELLE (LPN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JONELLE
Last Name:DEGARMO
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 1:4301 COLLEGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-9728
Mailing Address - Country:US
Mailing Address - Phone:140-432-5016
Mailing Address - Fax:
Practice Address - Street 1:4301 COLLEGE HILL RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9728
Practice Address - Country:US
Practice Address - Phone:140-432-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN069268164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse