Edna Denise Lackey, RN MBA PH.D

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

RN-257326 Issued in OH

Practice address

11260 Chester Rd
240
Cincinnati, OH 45246-4048

Phone

(513) 771-3412

Fax

(513) 771-1167

NPI assigned

Jul 9, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Doctor of Philosophy, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christ Tabernacle Ministries of Excellence Inc.

  • Primary Care Clinic/Center
  • Cincinnati, OH
  • NPI 1912314436

  Mental Health

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1922414044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11260 CHESTER RD",
            "address_2": "240",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452464048",
            "telephone_number": "513-771-3412",
            "fax_number": "513-771-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11260 CHESTER RD",
            "address_2": "240",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452464048",
            "telephone_number": "513-771-3412",
            "fax_number": "513-771-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "EDNA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "RN MBA PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "OH",
            "license": "RN-257326",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "OH",
            "license": "RN-257326",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "OH",
            "license": "RN-257326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara A Lackey
• Belinda Lackey
• Canisha N Lackey
• Christine A Lackey, M.S.-CCC-SLP
• Deborah Delores Lackey
• Juanita Lackey
• Kellie Lackey
• Wendy K Lackey, CRNA
• Lacombe Chiropractic Center PLLC
• Joel Robert Lacombe, D.C.

• Administrator Registered Nurse in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Administrator Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.