Healthcare Provider Details

I. General information

NPI: 1437077583
Provider Name (Legal Business Name): LENORA PASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 N LIMESTONE ST
SPRINGFIELD OH
45503-3612
US

IV. Provider business mailing address

1816 E WITTENBERG BLVD
SPRINGFIELD OH
45506-3121
US

V. Phone/Fax

Practice location:
  • Phone: 937-342-3029
  • Fax:
Mailing address:
  • Phone: 937-342-3029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: