Individual
MS. ANGELA KAYE EIDSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN-IP
Contact information
Practice address
5805 KEMP RD, CRESTLINE, OH 44827-9646
(419) 683-1214
Mailing address
305 E. MAIN ST., LEXINGTON, OH 44904-1350
(419) 512-9384
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-089611
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2574781
—
OH
Enumeration date
03/08/2006
Last updated
07/08/2007
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