Amanda Jonette Lare, LPN

Individual provider Active NPI Licensed Practical Nurse · Atwater, OH

NPI 1417694530 · NPPES record last updated May 19, 2022

Key facts

NPI
1417694530
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
172225 (OH)
Practice address
13969 German Church Rd
Atwater, OH 44201-9016
Phone
(330) 206-7249
NPI assigned
May 19, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
172225OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 172225 OH Yes

Addresses

Primary practice location

13969 German Church Rd
Atwater, OH 44201-9016

Mailing address

206 W Vine St
Alliance, OH 44601-1339
Phone (330) 206-7249

Other providers in Atwater, OH

All providers in Atwater, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.