Provider Demographics
NPI:1104624089
Name:HINCHEN, LAVONTE D
Entity type:Individual
Prefix:
First Name:LAVONTE
Middle Name:D
Last Name:HINCHEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-5840
Mailing Address - Country:US
Mailing Address - Phone:216-242-8946
Mailing Address - Fax:
Practice Address - Street 1:3340 W 50TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-5840
Practice Address - Country:US
Practice Address - Phone:216-242-8946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker