Healthcare Provider Details
I. General information
NPI: 1003591181
Provider Name (Legal Business Name): PAULA KENYA HURD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/16/2023
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5082 DONOVAN DR
CLEVELAND OH
44125-2052
US
IV. Provider business mailing address
5082 DONOVAN DR
CLEVELAND OH
44125-2052
US
V. Phone/Fax
- Phone: 216-254-0888
- Fax:
- Phone: 216-254-0888
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: