Provider Demographics
NPI:1396165197
Name:LEMONS, BEVERLY NICOLE
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:NICOLE
Last Name:LEMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-2328
Mailing Address - Country:US
Mailing Address - Phone:513-485-1646
Mailing Address - Fax:
Practice Address - Street 1:3114 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-2328
Practice Address - Country:US
Practice Address - Phone:513-485-1646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1133446164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse