Provider Demographics
NPI:1285169862
Name:ERO, OSAYI MARION (LPN)
Entity type:Individual
Prefix:
First Name:OSAYI
Middle Name:MARION
Last Name:ERO
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 1:2150 EQUESTRIAN DR
Mailing Address - Street 2:APT 2B
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6005
Mailing Address - Country:US
Mailing Address - Phone:510-750-9751
Mailing Address - Fax:
Practice Address - Street 1:2150 EQUESTRIAN DR
Practice Address - Street 2:APT 2B
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-6005
Practice Address - Country:US
Practice Address - Phone:510-750-9751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164808164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse