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NPI Code Detail

MEDICARE: LEKEISHA MARIE PENNINGTON

MEDICARE:   LEKEISHA MARIE PENNINGTON
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
1376J00000XHomemaker

General Provider Information

NPI Number : 1639881923
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEKEISHA MARIE PENNINGTON
Provider Business Mailing Address
First Line : 2045 W 101ST ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-3634
Country : US
Telephone Number : 216-681-3410
Fax Number :
Provider Business Practice Location Address
First Line : 2045 W 101ST ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-3634
Country : US
Telephone Number : 216-681-3410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2022
Last Update Date : 12/19/2022

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Directions to “ LEKEISHA MARIE PENNINGTON ” Practice Location

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