MEDICARE: LATASHA KNOWLES LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN.171140.MEDS-IV	OH

General Provider Information

NPI Number	:	1184288193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATASHA KNOWLES LPN

Provider Business Mailing Address
First Line	:	26900 GEORGE ZEIGER DR APT 313
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-7610
Country	:	US
Telephone Number	:	216-894-1337
Fax Number	:

Provider Business Practice Location Address
First Line	:	6700 PEARL RD
Second Line	:
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-3828
Country	:	US
Telephone Number	:	440-941-1933
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2019
Last Update Date	:	03/29/2023

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Directions to “ LATASHA KNOWLES LPN” Practice Location

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