MEDICARE: BELINDA ANDERSON I

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	2940527	OH

General Provider Information

NPI Number	:	1588076830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA ANDERSON I

Provider Business Mailing Address
First Line	:	4187 W 140TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-1569
Country	:	US
Telephone Number	:	216-323-8422
Fax Number	:

Provider Business Practice Location Address
First Line	:	4187 W 140TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-1569
Country	:	US
Telephone Number	:	216-323-8422
Fax Number	:

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

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	05/21/2014

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