Healthcare Provider Details

I. General information

NPI: 1821923277
Provider Name (Legal Business Name): MARANDA JOLENE LUCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1419 N HIGH ST
LANCASTER OH
43130-1048
US

IV. Provider business mailing address

1419 NORTH HIGH ST
LANCASTER OHIO OH
43130
US

V. Phone/Fax

Practice location:
  • Phone: 740-279-0576
  • Fax:
Mailing address:
  • Phone: 740-279-0576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberUU624137
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: