Provider Demographics
NPI:1194951566
Name:TESI, JANUARY LEE (LPN)
Entity type:Individual
Prefix:
First Name:JANUARY
Middle Name:LEE
Last Name:TESI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 BIG PLAIN CIRCLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9333
Mailing Address - Country:US
Mailing Address - Phone:614-496-7746
Mailing Address - Fax:
Practice Address - Street 1:4950 BIG PLAIN CIRCLEVILLE RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9333
Practice Address - Country:US
Practice Address - Phone:614-496-7746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.128862IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse