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General NPI Number Information
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NPI Number | 1649526302
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Entity Type | Individual
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Provider Name | LASHYA M ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 446 RICHMOND PARK E
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-1813
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Country | US
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Telephone | 216-482-4623
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Fax |
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Provider Business Mailing Address
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Address Line | 22701 LAKE SHORE BLVD
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City | EUCLID
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State | OH
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Zip | 44123-1301
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Country | US
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Telephone | 216-356-0097
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 158912
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License Number State | OH
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