IndividualActive
Autumn Trace, LPN
NPI 1316084346 · Licensed Practical Nurse · Jackson, OH
Provider details
- NPI number
- 1316084346
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- License
- PN050719 (OH)
Specialties & taxonomies
Nursing Service Providers
Practice location
710 Jackson Hill Rd
Jackson, OH 45640-9301
Phone: (740) 286-0212
Approximate (ZIP-level) locationGet directions
Mailing address
710 Jackson Hill Rd
Jackson, OH 45640-9301
Registry dates
- Enumerated
- 2007-01-31
- Last updated
- 2007-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.