Provider Demographics
NPI:1730860255
Name:HOUSTON, LYNETTE ANDREA (RN)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:ANDREA
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5759 WINTROP AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-2918
Mailing Address - Country:US
Mailing Address - Phone:513-605-0771
Mailing Address - Fax:
Practice Address - Street 1:5759 WINTROP AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-2918
Practice Address - Country:US
Practice Address - Phone:513-605-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide