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General NPI Number Information
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NPI Number | 1669892196
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Entity Type | Organization
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Legal Business Name | COURTNEY SPEED
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 19101 SHAWNEE AVE
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City | CLEVELAND
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State | OH
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Zip | 44119-2715
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Country | US
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Telephone | 216-970-4870
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Fax |
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Provider Business Mailing Address
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Address Line | 19101 SHAWNEE AVE.
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City | CLEVELAND
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State | OH
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Zip | 44119
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Country | US
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Telephone | 216-970-4870
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MS. COURTNEY LYNNE SPEED
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Credential | LPN
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Telephone | 216-970-4870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 150548
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License Number State | OH
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