Provider Demographics
NPI:1063686871
Name:DURBIN, LOREE ALENE (LPN)
Entity type:Individual
Prefix:MS
First Name:LOREE
Middle Name:ALENE
Last Name:DURBIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:LOREE
Other - Middle Name:ALENE
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:701 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-3847
Mailing Address - Country:US
Mailing Address - Phone:330-644-4241
Mailing Address - Fax:
Practice Address - Street 1:701 MOORE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-3847
Practice Address - Country:US
Practice Address - Phone:330-644-4241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 089869164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2087996OtherMEDICAID PROVIDER