Provider Demographics
NPI:1366121477
Name:DUCKSWORTH-BEARDEN, SYLVIA D
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:D
Last Name:DUCKSWORTH-BEARDEN
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 1:19004 CHICKASAW AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2730
Mailing Address - Country:US
Mailing Address - Phone:216-256-4815
Mailing Address - Fax:
Practice Address - Street 1:19004 CHICKASAW AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2730
Practice Address - Country:US
Practice Address - Phone:216-256-4815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH423567163W00000X
343900000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)