Provider Demographics
NPI:1972709475
Name:LOGAN-HORHN, ANGELI Y (LPN)
Entity type:Individual
Prefix:MRS
First Name:ANGELI
Middle Name:Y
Last Name:LOGAN-HORHN
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 1:16010 DELREY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1364
Mailing Address - Country:US
Mailing Address - Phone:216-752-1171
Mailing Address - Fax:
Practice Address - Street 1:16010 DELREY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1364
Practice Address - Country:US
Practice Address - Phone:216-799-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN116888 MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse