Provider Demographics
NPI:1114261674
Name:ELUM, LAKEISHA T (DOULA)
Entity Type:Individual
Prefix:MRS
First Name:LAKEISHA
Middle Name:T
Last Name:ELUM
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 NICHOLS ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1531
Mailing Address - Country:US
Mailing Address - Phone:856-405-9574
Mailing Address - Fax:
Practice Address - Street 1:11 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1531
Practice Address - Country:US
Practice Address - Phone:856-405-9574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula