Individual provider · Type 1 NPI

Theresa Maria Detomaso, LPN

Licensed Practical Nurse · Fort Recovery, OH

NPI number 1164756649 Active

Practice location

806 Blue Jacket Dr, Apt. B
Fort Recovery, OH 45846-0645

Mailing address

PO Box 645
Fort Recovery, OH 45846-0645

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000XPN130615IV (OH)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1164756649

Theresa Maria Detomaso, LPN's National Provider Identifier is 1164756649, issued on Sep 30, 2009. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Fort Recovery, OH. The record was last updated on Sep 30, 2009.