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General NPI Number Information
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NPI Number | 1538369905
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Entity Type | Individual
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Provider Name | LEONDREA VANESSA MUKES RN
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Gender | Female
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 1098 MEADOWIND CT
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City | CINCINNATI
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State | OH
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Zip | 45231-4607
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Country | US
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Telephone | 513-373-0000
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Fax | 513-429-4798
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Provider Business Mailing Address
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Address Line | 1098 MEADOWIND CT
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City | CINCINNATI
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State | OH
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Zip | 45231-4607
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Country | US
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Telephone | 513-373-0000
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Fax | 513-429-4798
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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 | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN 321199
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License Number State | OH
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