IndividualActive
Tina Theaker, LPN
NPI 1184864480 · Licensed Practical Nurse · Fredericktown, OH
Provider details
- NPI number
- 1184864480
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- License
- PN095964 (OH)
Specialties & taxonomies
Nursing Service Providers
Practice location
19880 Knox Lake Rd
Fredericktown, OH 43019-9669
Phone: (740) 694-1761
Approximate (ZIP-level) locationGet directions
Mailing address
19880 Knox Lake Rd
Fredericktown, OH 43019-9669
Registry dates
- Enumerated
- 2009-02-26
- Last updated
- 2009-02-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.