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NPI Code Detail

MEDICARE: SHAKINAH N PAGE LPN

MEDICARE: SHAKINAH N PAGE 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
1163WA0400XAddiction (Substance Use Disorder) Registered Nurse459104OH

Other Identifiers

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

General Provider Information

NPI Number : 1346777323
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAKINAH N PAGE LPN
Provider Business Mailing Address
First Line : 100 HIGHVIEW BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-6023
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 HIGHVIEW BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-6023
Country : US
Telephone Number : 148-269-9956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2017
Last Update Date : 07/13/2021

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Directions to “ SHAKINAH N PAGE LPN” Practice Location

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