Healthcare Provider Details

I. General information

NPI: 1336937077
Provider Name (Legal Business Name): ERON LANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/05/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 BROADWAY AVE
YOUNGSTOWN OH
44504-1752
US

IV. Provider business mailing address

1960 E COUNTY LINE RD
MINERAL RIDGE OH
44440-9451
US

V. Phone/Fax

Practice location:
  • Phone: 330-743-5309
  • Fax:
Mailing address:
  • Phone: 330-531-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.192154
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: