MEDICARE: ZAKIYYAH M TRIPLETT

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

General Provider Information

NPI Number	:	1942712187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAKIYYAH M TRIPLETT

Provider Business Mailing Address
First Line	:	PO BOX 351392
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43635-1392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 N HOLLAND SYLVANIA RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-4910
Country	:	US
Telephone Number	:	419-309-2891
Fax Number	:

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

Provider Enumeration Date	:	10/27/2017
Last Update Date	:	07/30/2019

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Directions to “ ZAKIYYAH M TRIPLETT ” Practice Location

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