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Individual

LEEANDRA LD ETHERIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3260 N HAYDEN RD # 210-14, SCOTTSDALE, AZ 85251-6649
(602) 435-7700
Mailing address
3260 N HAYDEN RD STE 210-14, SCOTTSDALE, AZ 85251-6649
(480) 659-3453
(480) 809-4646

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
3747A0650X
Attendant Care Provider
Primary
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide
376J00000X
Homemaker
376K00000X
Nurse's Aide

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
152870612
NPI
AZ
05
5
AZ
05
87-1421001
AZ
01
871421001
IN HOME HEALTH CARE
AZ
Enumeration date
10/06/2021
Last updated
08/05/2024
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