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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | LATORA BERNICE BRISTOW · LaTora Bristow | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Provider ID: 0088384 | [sources] | |||
| First name | LaTora | [sources] | |||
| Last name | Bristow | [sources] | |||
| Middle name | BERNICE | [sources] | |||
| NPI | 1528311610 | [sources] | |||
| Sector | 38 - Non-Agency Nurse PDN -- RN OR LPN | [sources] | |||
| Position | NURSE/NURSES AIDE (IND- LIC HC SERV PRO) | [sources] | |||
| Address | 194 KENRIDGE ROAD, FAIRLAWN, OH 44333 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded or suspended from Ohio's Medicaid program.
United States · ODM
People and companies excluded from Federally funded health care programs
United States · OIG
us-fed-excl-latora-bernice-bristow-44333-fairlawn · us-medoh-d0624dca819ae21f66964ad50825467c501c1b7bFor experts: raw data explorer
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| United States | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - |