Provider Demographics
NPI:1750966156
Name:LAHKE, MIA KATHERINE
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:KATHERINE
Last Name:LAHKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 QUEEN ANN CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2322
Mailing Address - Country:US
Mailing Address - Phone:513-505-0343
Mailing Address - Fax:
Practice Address - Street 1:7521 QUEEN ANN CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2322
Practice Address - Country:US
Practice Address - Phone:513-505-0343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker