MEDICARE: CAPRECE HENDERSON-ASHBY LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care
2	385HR2050X	Respite Care Camp
3	164W00000X	Licensed Practical Nurse	PN.149634-M-IV	OH
4	253Z00000X	In Home Supportive Care Agency
5	343900000X	Non-emergency Medical Transport (VAN)
6	372600000X	Adult Companion
7	374U00000X	Home Health Aide
8	376J00000X	Homemaker		OH

General Provider Information

NPI Number	:	1023454691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAPRECE HENDERSON-ASHBY LPN

Provider Business Mailing Address
First Line	:	1824 NASON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1678
Country	:	US
Telephone Number	:	614-312-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1824 NASON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1678
Country	:	US
Telephone Number	:	614-312-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2013
Last Update Date	:	02/06/2024

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