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General NPI Number Information
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NPI Number | 1912345695
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Entity Type | Organization
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Legal Business Name | LASHELLE HENDERSON
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 4823 STACY CT
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2936
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Country | US
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Telephone | 216-233-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 4823 STACY CT
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2936
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Country | US
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Telephone | 216-233-1983
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MS. LASHELLE HENDERSON
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Credential | MSN, RN, FNP-BC
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Telephone | 216-233-1983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | RN 30352
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License Number State | OH
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