Provider Demographics
NPI:1043892805
Name:CRIPPEN, LAKENYA (CPHT)
Entity Type:Individual
Prefix:
First Name:LAKENYA
Middle Name:
Last Name:CRIPPEN
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 KEMPSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3721
Mailing Address - Country:US
Mailing Address - Phone:757-447-9224
Mailing Address - Fax:757-447-9225
Practice Address - Street 1:475 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3721
Practice Address - Country:US
Practice Address - Phone:757-447-9224
Practice Address - Fax:757-447-9225
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230023793183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician