Provider Demographics
NPI:1386784775
Name:ROMEO, JUDIANN M (RN, CCM)
Entity type:Individual
Prefix:
First Name:JUDIANN
Middle Name:M
Last Name:ROMEO
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CLINGAN RD
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-2126
Mailing Address - Country:US
Mailing Address - Phone:330-755-3575
Mailing Address - Fax:330-755-3675
Practice Address - Street 1:75 CLINGAN RD
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-2126
Practice Address - Country:US
Practice Address - Phone:330-755-3575
Practice Address - Fax:330-755-3675
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN267212171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator