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MRS. COLEEN T PHELPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1420 THATCHER DR, PAINESVILLE, OH 44077-5002
(440) 521-0146
Mailing address
1420 THATCHER DR, PAINESVILLE, OH 44077-5002
(440) 521-0146

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-093713
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2533940
OH
Enumeration date
03/28/2007
Last updated
07/09/2007
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