Larry Workman, LPN

Individual provider Active NPI Licensed Practical Nurse · Mantua, OH

NPI 1821300997 · NPPES record last updated Jul 7, 2010

Key facts

NPI
1821300997
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN.127167-M-IV (OH)
Practice address
9933 State Route 700
Mantua, OH 44255-9730
Phone
(216) 246-1325
NPI assigned
Jul 6, 2010
Sex
Male
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
PN.127167-M-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.127167-M-IV OH Yes

Addresses

Primary practice location

9933 State Route 700
Mantua, OH 44255-9730

Mailing address

9933 State Route 700
Mantua, OH 44255-9730
Phone (216) 246-1325

Other providers in Mantua, OH

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

Sources for this page

Verify at the official NPI Registry.