Individual
LEEANDRA LD ETHERIDGE
Active
Individual
LEEANDRA LD ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
Update your record
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