MEDICARE: MRS. LEKITA LAMONA NANCE SCOTT NURSE PRACTITIONER

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	164W00000X	Licensed Practical Nurse	PN.105775-IV	OH
2	207QA0505X	Adult Medicine Physician	0027350	OH
3	363LF0000X	Family Nurse Practitioner	LE-00033125	OH

General Provider Information

NPI Number	:	1831317874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEKITA LAMONA NANCE SCOTT NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1111 E 145TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3605
Country	:	US
Telephone Number	:	216-541-1992
Fax Number	:	216-510-3499

Provider Business Practice Location Address
First Line	:	2000 LEE RD STE 215
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-2559
Country	:	US
Telephone Number	:	216-541-1992
Fax Number	:	216-510-3499

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	04/23/2024

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