MEDICARE: ROXANNE LAUDERDALE

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	374U00000X	Home Health Aide
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1932795853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE LAUDERDALE

Provider Business Mailing Address
First Line	:	655 BROADWAY AVE
Second Line	:
City	:	BEDFORD
State	:	OH
Zip	:	44146-3504
Country	:	US
Telephone Number	:	216-310-9432
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 BROADWAY AVE
Second Line	:
City	:	BEDFORD
State	:	OH
Zip	:	44146-3504
Country	:	US
Telephone Number	:	216-310-9432
Fax Number	:

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

Provider Enumeration Date	:	12/15/2020
Last Update Date	:	04/29/2026

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Directions to “ ROXANNE LAUDERDALE ” Practice Location

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