Provider Demographics
NPI:1285101287
Name:DUKE, NILA MARIE (LPN)
Entity type:Individual
Prefix:MS
First Name:NILA
Middle Name:MARIE
Last Name:DUKE
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 1:2173 BALAIS CT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1394
Mailing Address - Country:US
Mailing Address - Phone:330-423-5827
Mailing Address - Fax:614-629-5811
Practice Address - Street 1:2173 BALAIS CT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1394
Practice Address - Country:US
Practice Address - Phone:330-423-5827
Practice Address - Fax:614-629-5811
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH086596164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse