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General NPI Number Information
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NPI Number | 1346992625
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Entity Type | Individual
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Provider Name | LAVADA S KING
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Gender | Female
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Dates
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Enumeration Date | 01/19/2022
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 344 GRACE ST
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City | MANSFIELD
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State | OH
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Zip | 44902-1173
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Country | US
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Telephone | 419-612-1581
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Fax |
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Provider Business Mailing Address
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Address Line | 344 GRACE STREET
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City | MANSFIELD
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State | OH
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Zip | 44902-1571
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Country | US
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Telephone | 419-612-1581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 401680850814
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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