Healthcare Provider Details

I. General information

NPI: 1386981272
Provider Name (Legal Business Name): MRS. LATOYA ARTISHA REEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2013
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16617 LIPTON AVE 16617 LIPTON AVE
CLEVELAND OH
44128-3615
US

IV. Provider business mailing address

16617 LIPTON AVE 16617 LIPTON AVE
CLEVELAND OH
44128-3615
US

V. Phone/Fax

Practice location:
  • Phone: 216-854-1520
  • Fax:
Mailing address:
  • Phone: 216-854-1520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: