Provider Demographics
NPI:1417137175
Name:LARUE, LAMIKIA PATRICE (RN)
Entity type:Individual
Prefix:
First Name:LAMIKIA
Middle Name:PATRICE
Last Name:LARUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2047
Mailing Address - Country:US
Mailing Address - Phone:216-780-7827
Mailing Address - Fax:
Practice Address - Street 1:3775 LOWELL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44121-2047
Practice Address - Country:US
Practice Address - Phone:216-780-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-11
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN414063163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse