Provider Demographics
NPI:1427450063
Name:RADFORD, DENISE A (LPN)
Entity type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:A
Last Name:RADFORD
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 1:141 ELK CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-4685
Mailing Address - Country:US
Mailing Address - Phone:513-218-0258
Mailing Address - Fax:
Practice Address - Street 1:2335 RONDOWA AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-2532
Practice Address - Country:US
Practice Address - Phone:937-397-8395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.129830164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse