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Individual

DIONNA ROXANE BEACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
105 S ROBINSON ST, TIRO, OH 44887-9625
(419) 565-4494
Mailing address
105 S ROBINSON ST, P.O. BOX 14, TIRO, OH 44887-9625
(419) 565-4494

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 126622 M IV
OH
164X00000X
Licensed Vocational Nurse
PN 126622 M IV
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74684
ATN
OH
Enumeration date
10/24/2013
Last updated
01/17/2014
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