Provider Demographics
NPI:1467918029
Name:RADCLIFF, LACHAYA MARY (APRN)
Entity type:Individual
Prefix:
First Name:LACHAYA
Middle Name:MARY
Last Name:RADCLIFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LACHAYA
Other - Middle Name:MARY
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4600 MONTGOMERY RD STE 400
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4813 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1403
Practice Address - Country:US
Practice Address - Phone:866-510-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1129719363LP0808X
NC5012301363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC254281OtherREGISTERED NURSE
NC5012301OtherNURSE PRACTITIONER