Provider Demographics
NPI:1043459613
Name:BLOODSAW-SCOTT, LASHONDA KENYA (PA)
Entity Type:Individual
Prefix:MS
First Name:LASHONDA
Middle Name:KENYA
Last Name:BLOODSAW-SCOTT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LASHONDA
Other - Middle Name:KENYA
Other - Last Name:BLOODSAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1735 N BROWN RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8158
Mailing Address - Country:US
Mailing Address - Phone:352-383-4505
Mailing Address - Fax:678-218-4041
Practice Address - Street 1:1735 N BROWN RAOD
Practice Address - Street 2:HEALTH CARE PARTNERS
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-3872
Practice Address - Country:US
Practice Address - Phone:352-383-4505
Practice Address - Fax:678-218-4041
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5340363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant