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Individual

CHRISTINA SHANNON MEDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
8515 ROYAL RIDGE DR, PARMA, OH 44129-6030
(440) 667-7570
Mailing address
8515 ROYAL RIDGE DR, PARMA, OH 44129-6030
(440) 667-7570

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
140403
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140403
LPN
OH
05
2768670
OH
Enumeration date
07/10/2012
Last updated
07/10/2012
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