Individual
ISHIKIA CAROLINE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1358 HAWTHORNE AVE, LORAIN, OH 44052-1139
(440) 420-3749
Mailing address
1358 HAWTHORNE AVE, LORAIN, OH 44052-1139
(440) 420-3749
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN158308
OH
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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