Provider Demographics
NPI:1679975023
Name:LIGHTNER, NANCY
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 HINCKLEY HILLS RD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9306
Mailing Address - Country:US
Mailing Address - Phone:330-278-3148
Mailing Address - Fax:
Practice Address - Street 1:1675 HINCKLEY HILLS RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9306
Practice Address - Country:US
Practice Address - Phone:330-278-3148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN120410-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse