Provider Demographics
NPI:1174951743
Name:BLADON, RAMONA (LVN)
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:
Last Name:BLADON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30951 HANOVER LN
Mailing Address - Street 2:APT 2406
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-6629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30951 HANOVER LN
Practice Address - Street 2:APT 2406
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-6629
Practice Address - Country:US
Practice Address - Phone:310-904-4695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA271106164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse