Healthcare Provider Details

I. General information

NPI: 1831317874
Provider Name (Legal Business Name): LEKITA LAMONA NANCE SCOTT NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 LEE RD STE 215
CLEVELAND HEIGHTS OH
44118-2559
US

IV. Provider business mailing address

1111 E 145TH ST
CLEVELAND OH
44110-3605
US

V. Phone/Fax

Practice location:
  • Phone: 216-541-1992
  • Fax: 216-510-3499
Mailing address:
  • Phone: 216-541-1992
  • Fax: 216-510-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.105775-IV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number0027350
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLE-00033125
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: