Individual
ILENE M EVERHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1343 STATE ROUTE 131, LYNCHBURG, OH 45142-9719
(937) 302-9662
Mailing address
1343 STATE ROUTE 131, LYNCHBURG, OH 45142-9719
(937) 302-9662
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.132223 IV
OH
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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