Kierston Dawn Gladden

Individual provider Active NPI In Home Supportive Care Agency · Lakeview, OH

NPI 1558069161 · NPPES record last updated Feb 22, 2023

Key facts

NPI
1558069161
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
325 Hull St
Lakeview, OH 43331-9470
Phone
(419) 860-2095
NPI assigned
Feb 22, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

325 Hull St
Lakeview, OH 43331-9470

Mailing address

325 Hull St
Lakeview, OH 43331-9470
Phone (419) 860-2095

Other providers in Lakeview, OH

All providers in Lakeview, OH · In Home Supportive Care Agency in Ohio

Sources for this page

Verify at the official NPI Registry.