Provider Demographics
NPI:1457166142
Name:MOONEY, LORENA R (LPN)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:R
Last Name:MOONEY
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 1:156 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST FARMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44491-8746
Mailing Address - Country:US
Mailing Address - Phone:330-766-3355
Mailing Address - Fax:
Practice Address - Street 1:156 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST FARMINGTON
Practice Address - State:OH
Practice Address - Zip Code:44491-8746
Practice Address - Country:US
Practice Address - Phone:330-766-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH158468164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse