=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821951401
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LADAJAIH MARIE BISHOP-HARRIS STNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2025
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1709 SHENANDOAH RD
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43607-1670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-377-9157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1709 SHENANDOAH RD
-----------------------------------------------------
City | TOLEDO
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43607-1670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 567-377-9157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376K00000X
-----------------------------------------------------
Taxonomy Name | Nurse's Aide
-----------------------------------------------------
License Number | 402107650918
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------