Healthcare Provider Details

I. General information

NPI: 1548484421
Provider Name (Legal Business Name): GWENDOLYN BELINDA THOMPSON STNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 RICHMOND PARK E SUITE 612C
RICHMOND HEIGHTS OH
44143-1833
US

IV. Provider business mailing address

440 RICHMOND PARK E SUITE 612C
RICHMOND HEIGHTS OH
44143-1833
US

V. Phone/Fax

Practice location:
  • Phone: 440-446-1658
  • Fax:
Mailing address:
  • Phone: 440-446-1658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: