Individual
AQUARIUS ANN FENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6014 LAKE CLUB CT, COLUMBUS, OH 43232-3147
(419) 202-8171
Mailing address
6014 LAKE CLUB CT, COLUMBUS, OH 43232-3147
(419) 202-8171
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN. 140658
OH
Other
Enumeration date
08/20/2010
Last updated
08/20/2010
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