Cynthia M. Roe, LPN
Individual provider Active NPI Licensed Practical Nurse · Ray, OH
NPI 1659664712 · NPPES record last updated May 24, 2011
Key facts
- NPI
- 1659664712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- P.N. 119839-IV (OH)
- Practice address
- 1026 Sour Run Rd
Ray, OH 45672-9614 - Phone
- (740) 286-6171
- Fax
- (740) 286-6171
- NPI assigned
- May 24, 2011
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| P.N. 119839-IV | OH | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P.N. 119839-IV | OH | Yes |
Addresses
Primary practice location
1026 Sour Run Rd
Ray, OH 45672-9614
Mailing address
1026 Sour Run Rd
Ray, OH 45672-9614
Phone (740) 286-6171
Other providers in Ray, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.