Provider Demographics
NPI:1962056226
Name:DOHO, LUCIENNE (FNP,MSN, BSN)
Entity type:Individual
Prefix:
First Name:LUCIENNE
Middle Name:
Last Name:DOHO
Suffix:
Gender:F
Credentials:FNP,MSN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6975 W 130TH ST
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44130-7821
Mailing Address - Country:US
Mailing Address - Phone:440-465-4032
Mailing Address - Fax:
Practice Address - Street 1:6975 W 130TH ST
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-7821
Practice Address - Country:US
Practice Address - Phone:440-088-8874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2021-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH380229163W00000X
OHAPRN.CNP.0028428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse