Provider Demographics
NPI:1124610472
Name:LLOYD, MANDI LEIGH (CNA)
Entity type:Individual
Prefix:
First Name:MANDI
Middle Name:LEIGH
Last Name:LLOYD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-1239
Mailing Address - Country:US
Mailing Address - Phone:231-203-1323
Mailing Address - Fax:
Practice Address - Street 1:643 E LAKE ST
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-1239
Practice Address - Country:US
Practice Address - Phone:231-203-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty