MEDICARE: LAKEYSHA SWAN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	251E00000X	Home Health Agency
3	261QS0132X	Ophthalmologic Surgery Clinic/Center
4	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2345556	OTHER	44677777
2	3308085869	OTHER	PHONE
3	3308085869	OTHER	MESSENGER

General Provider Information

NPI Number	:	1508489725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKEYSHA SWAN

Provider Business Mailing Address
First Line	:	2165 17TH ST SW
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44314-2315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2165 17TH ST SW
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44314-2315
Country	:	US
Telephone Number	:	330-808-5869
Fax Number	:

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

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	07/08/2025

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Directions to “ LAKEYSHA SWAN ” Practice Location

Language	Start Address	Practice Location

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