Provider Demographics
NPI:1538574702
Name:OLDFIELD, ROY (PN)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:OLDFIELD
Suffix:
Gender:M
Credentials:PN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SOLERA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-9135
Mailing Address - Country:US
Mailing Address - Phone:978-606-1275
Mailing Address - Fax:
Practice Address - Street 1:1900 SOLERA DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-9135
Practice Address - Country:US
Practice Address - Phone:978-606-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH152968164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse