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NPI Code Detail

MEDICARE: TEIA MONIQUE TODD LPN

MEDICARE:   TEIA MONIQUE TODD  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
1164W00000XLicensed Practical NursePN139597OH

General Provider Information

NPI Number : 1265730543
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEIA MONIQUE TODD LPN
Provider Business Mailing Address
First Line : 1789 E 90TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2059
Country : US
Telephone Number : 216-744-6004
Fax Number :
Provider Business Practice Location Address
First Line : 1789 E 90TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-2059
Country : US
Telephone Number : 216-744-6004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2011
Last Update Date : 11/18/2013

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Directions to “ TEIA MONIQUE TODD LPN” Practice Location

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