Provider Demographics
NPI:1114668332
Name:CARMON, LAMONICA D (ASCP)
Entity Type:Individual
Prefix:
First Name:LAMONICA
Middle Name:D
Last Name:CARMON
Suffix:
Gender:F
Credentials:ASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4094 LELAND RD
Mailing Address - Street 2:
Mailing Address - City:GRIFTON
Mailing Address - State:NC
Mailing Address - Zip Code:28530-9018
Mailing Address - Country:US
Mailing Address - Phone:252-702-2598
Mailing Address - Fax:
Practice Address - Street 1:601 COUNTRY CLUB DR STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6124
Practice Address - Country:US
Practice Address - Phone:252-702-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68839246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy