Provider Demographics
NPI:1699170647
Name:WIREMAN, MAGGIE (LPN)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:WIREMAN
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 1:37707 US ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8987
Mailing Address - Country:US
Mailing Address - Phone:740-701-2288
Mailing Address - Fax:
Practice Address - Street 1:37707 US ROUTE 35
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8987
Practice Address - Country:US
Practice Address - Phone:740-701-2288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-01
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.154856-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse