Individual
MRS. GAYLE DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
6599 W MIDDLETOWN RD, CANFIELD, OH 44406-9417
(330) 503-1064
Mailing address
6599 W MIDDLETOWN RD, CANFIELD, OH 44406-9417
(330) 503-1064
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-052307
OH
164W00000X
Licensed Practical Nurse
PN074657L
PA
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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