Provider Demographics
NPI:1316158231
Name:MITCHELL, LAWANDA TRENEIA (LPN)
Entity type:Individual
Prefix:MRS
First Name:LAWANDA
Middle Name:TRENEIA
Last Name:MITCHELL
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 1:48 W HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-2311
Mailing Address - Country:US
Mailing Address - Phone:330-797-0338
Mailing Address - Fax:
Practice Address - Street 1:3792 STARRS CENTRE DR
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8002
Practice Address - Country:US
Practice Address - Phone:330-702-1411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN111945164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse