Provider Demographics
NPI:1053186965
Name:WORKMAN, FREDERICK WAYNE (HOME HEALTH AIDE)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:WAYNE
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:OH
Mailing Address - Zip Code:45827-9587
Mailing Address - Country:US
Mailing Address - Phone:567-376-0777
Mailing Address - Fax:
Practice Address - Street 1:200 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:OH
Practice Address - Zip Code:45827-9587
Practice Address - Country:US
Practice Address - Phone:567-376-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide