Provider Demographics
NPI:1124488150
Name:MERRITT, LAKIDA LONISHA (LPN)
Entity type:Individual
Prefix:
First Name:LAKIDA
Middle Name:LONISHA
Last Name:MERRITT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 LEE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1725
Mailing Address - Country:US
Mailing Address - Phone:216-609-6575
Mailing Address - Fax:
Practice Address - Street 1:1708 LEE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44118-1725
Practice Address - Country:US
Practice Address - Phone:216-609-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.155228-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse