Individual
BEVERLY JEAN VANWORMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
380 WAYNE ST, MANSFIELD, OH 44902-1142
(419) 571-9862
Mailing address
380 WAYNE ST, MANSFIELD, OH 44902-1142
(419) 571-9862
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN106029
OH
Other
Enumeration date
06/20/2009
Last updated
06/20/2009
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