Provider Demographics
NPI:1023891207
Name:LAKES, HANNAH SERENITY
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:SERENITY
Last Name:LAKES
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 1:643 DAYTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3462
Mailing Address - Country:US
Mailing Address - Phone:513-889-9417
Mailing Address - Fax:
Practice Address - Street 1:643 DAYTON ST APT 2
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3462
Practice Address - Country:US
Practice Address - Phone:513-889-9417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver