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TRACY LYNN CUSTER

>> Licensed Practical Nurse >> Nursing Service Providers

Registrant NPI Number: 1629576624

Individual Registrant:
 TRACY LYNN CUSTER 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
105 PRIMROSE PL  SPENCERVILLE, OH 45887-1252 US
Tel: 419-236-2755  Fax: --

Contact information for business:
311 E MARKET ST FL 3  LIMA, OH 45801-4535 US
Tel: 419-222-4474  Fax: --

Registration Information:
NPI: 1629576624
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y164W00000XNursing Service Providers
Licensed Practical Nurse
OH161430

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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