Individual
ANITA RENEE LARGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
602 WATER ST, GREENUP, KY 41144-1053
(606) 232-2067
Mailing address
602 WATER ST, GREENUP, KY 41144-1053
(606) 232-2067
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
094108
OH
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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