Individual
GEORGANNA LOUISE TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
397 E 222ND ST, B15, EUCLID, OH 44123-1747
(216) 299-9977
Mailing address
397 E 222ND ST, B15, EUCLID, OH 44123-1747
(216) 299-9977
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
121595
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2639989
—
OH
Enumeration date
01/09/2007
Last updated
07/09/2007
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