Provider Demographics
NPI:1104259969
Name:ARMOUR, KELLY LAVETTE (LPN)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:LAVETTE
Last Name:ARMOUR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:LAVETTE
Other - Last Name:ARMOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:3040 BELMONT AVE STE C
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1836
Mailing Address - Country:US
Mailing Address - Phone:330-759-0276
Mailing Address - Fax:330-759-0030
Practice Address - Street 1:136 WESTCHESTER DR STE 5
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3965
Practice Address - Country:US
Practice Address - Phone:330-270-1400
Practice Address - Fax:330-270-1404
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-15
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.126964.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse