MEDICARE: DEANNA LEDGER STNA

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	376K00000X	Nurse's Aide	401431670812	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306257860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA LEDGER STNA

Provider Business Mailing Address
First Line	:	10290 PLEASANT LAKE BLVD APT F9
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44130-7464
Country	:	US
Telephone Number	:	440-539-5729
Fax Number	:

Provider Business Practice Location Address
First Line	:	10290 PLEASANT LAKE BLVD APT F9
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44130-7464
Country	:	US
Telephone Number	:	440-539-5729
Fax Number	:

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

Provider Enumeration Date	:	05/17/2014
Last Update Date	:	05/17/2014

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Directions to “ DEANNA LEDGER STNA” Practice Location

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