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Individual
MECHELLE DAWN VANDYNE
Active
Individual
MECHELLE DAWN VANDYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
23036
WV
164W00000X
Licensed Practical Nurse
Primary
PN.097181-MEDS
OH
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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