Individual
ANDREA LAUREN PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
530 S MAIN ST, LIMA, OH 45804-1500
(419) 222-1168
Mailing address
530 S MAIN ST, LIMA, OH 45804-1240
(567) 319-9609
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.165516.MEDS-IV
OH
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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