Provider Demographics
NPI:1730418955
Name:SIETMAN, DARLENE AMEY (LPN)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:AMEY
Last Name:SIETMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-5556
Mailing Address - Country:US
Mailing Address - Phone:440-813-0609
Mailing Address - Fax:
Practice Address - Street 1:1102 W 39TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-5556
Practice Address - Country:US
Practice Address - Phone:440-813-0609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN089341164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse