Provider Demographics
NPI:1952931503
Name:ABDULLAH, LAUICE NICOLE
Entity Type:Individual
Prefix:
First Name:LAUICE
Middle Name:NICOLE
Last Name:ABDULLAH
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 1:41 FINCASTLE LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-4913
Mailing Address - Country:US
Mailing Address - Phone:234-232-5910
Mailing Address - Fax:
Practice Address - Street 1:41 FINCASTLE LN
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-4913
Practice Address - Country:US
Practice Address - Phone:234-232-5910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide