Penni Joy Defazio, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

075199 Issued in OH

Practice address

4034 Hopewell Church Rd SW
Lancaster, OH 43130-8053

Phone

(740) 654-2259

NPI assigned

Oct 22, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319241600000",
    "number": "1467738435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 HOPEWELL CHURCH RD SW",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308053",
            "telephone_number": "740-654-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4034 HOPEWELL CHURCH RD SW",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308053",
            "telephone_number": "740-654-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "PENNI",
        "middle_name": "JOY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-22",
        "last_updated": "2011-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "075199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Decaro, QMHSBA, CMSBA
• Angelique Decker
• Chelsea Alizabeth Decker
• Jon B Decker, DDS
• Michelle Decoste
• Francis Paul Degenova, DO
• Kilynn Deible
• Patrice Dejesus
• Nichole Ruth Deleon, SOCIAL WORK TRAINEE
• Leslie Carl Delong, LMT

• Licensed Practical Nurse in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.