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NPI Code Detail

MEDICARE: KEENA LANNEA MCDONALD LPN

MEDICARE:   KEENA LANNEA MCDONALD  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
1164W00000XLicensed Practical Nurse165172OH

General Provider Information

NPI Number : 1740704154
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEENA LANNEA MCDONALD LPN
Provider Business Mailing Address
First Line : 5539 OLD BLUE ROCK RD APT 59
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-2729
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5539 OLD BLUE ROCK RD APT 59
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-2729
Country : US
Telephone Number : 513-394-9450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2017
Last Update Date : 07/27/2017

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Directions to “ KEENA LANNEA MCDONALD LPN” Practice Location

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