Healthcare Provider Details

I. General information

NPI: 1255171575
Provider Name (Legal Business Name): MS. LASHAWNDA CARTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 05/27/2024
Certification Date: 05/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 GLENMORE AVE APT 2
CINCINNATI OH
45211-6474
US

IV. Provider business mailing address

3161 GLENMORE AVE APT 2
CINCINNATI OH
45211-6474
US

V. Phone/Fax

Practice location:
  • Phone: 513-377-3150
  • Fax:
Mailing address:
  • Phone: 513-377-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: