Provider Demographics
NPI:1912049149
Name:SINGH, LUCINDA JEAN LESLIE
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:JEAN LESLIE
Last Name:SINGH
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 1:5260 STATE ROUTE 781
Mailing Address - Street 2:
Mailing Address - City:PEEBLES
Mailing Address - State:OH
Mailing Address - Zip Code:45660-9526
Mailing Address - Country:US
Mailing Address - Phone:937-587-1829
Mailing Address - Fax:
Practice Address - Street 1:5260 STATE ROUTE 781
Practice Address - Street 2:
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660-9526
Practice Address - Country:US
Practice Address - Phone:937-587-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300006520391374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2691387Medicaid