Active NPI
Gleneisha Latriece Fannin, LPN
- Licensed Practical Nurse
- Bedford Heights, OH
National Provider Identifier
1124323159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 143053
- Practice address
- 6000 Bear Creek Dr
127
Bedford Heights, OH 44146-2971 - Phone
- (216) 313-2884
- NPI assigned
- Jan 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 143053 | OH | Primary |
Addresses
Primary practice location
6000 Bear Creek Dr
127
Bedford Heights, OH 44146-2971
Mailing address
6000 Bear Creek Dr
127
Bedford Heights, OH 44146-2971
Phone (216) 313-2884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143053 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295740800000",
"number": "1124323159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6000 BEAR CREEK DR",
"address_2": "127",
"city": "BEDFORD HEIGHTS",
"state": "OH",
"postal_code": "441462971",
"telephone_number": "216-313-2884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 BEAR CREEK DR",
"address_2": "127",
"city": "BEDFORD HEIGHTS",
"state": "OH",
"postal_code": "441462971",
"telephone_number": "216-313-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANNIN",
"first_name": "GLENEISHA",
"middle_name": "LATRIECE",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-23",
"last_updated": "2011-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "143053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.