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Individual

MS. JANALEE FRACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
7949 MOLINE DRIVE, THURSTON, OH 43157-0353
(740) 407-6109
Mailing address
PO BOX 353, THURSTON, OH 43157-0353
(740) 407-6109

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN078367
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2173893
PROVIDER NUMBER
OH
Enumeration date
09/07/2006
Last updated
07/08/2007
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