Healthcare Provider Details

I. General information

NPI: 1003796350
Provider Name (Legal Business Name): LACRICIA LADAWN DURHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5179 ASTER PARK DR APT 3002
WEST CHESTER OH
45011-8777
US

IV. Provider business mailing address

5179 ASTER PARK DR APT 3002
WEST CHESTER OH
45011-8777
US

V. Phone/Fax

Practice location:
  • Phone: 513-435-3059
  • Fax:
Mailing address:
  • Phone: 513-435-3059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: