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General NPI Number Information
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NPI Number | 1841674892
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Entity Type | Individual
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Provider Name | EVETTE CONWAY LPN
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Gender | Female
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1630 PARKER DR
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City | CLEVELAND
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State | OH
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Zip | 44124-3619
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Country | US
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Telephone | 216-254-3884
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Fax |
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Provider Business Mailing Address
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Address Line | 4296 E 131ST ST
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City | CLEVELAND
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State | OH
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Zip | 44105-6353
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Country | US
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Telephone | 216-254-3884
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN.158460-M-IV
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | OH
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