Provider Demographics
NPI:1194051342
Name:LENYARD, CANDACE LATRICE (LPN)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:LATRICE
Last Name:LENYARD
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 1:6100 LEE RD S
Mailing Address - Street 2:APT. 216
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-4538
Mailing Address - Country:US
Mailing Address - Phone:216-375-6640
Mailing Address - Fax:
Practice Address - Street 1:6100 LEE RD S
Practice Address - Street 2:APT. 216
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-4538
Practice Address - Country:US
Practice Address - Phone:216-375-6640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 125285164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse