Provider Demographics
NPI:1164081477
Name:LEKWAUWA, UKANA L
Entity Type:Individual
Prefix:
First Name:UKANA
Middle Name:L
Last Name:LEKWAUWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5511 REUNION PT APT 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4197
Mailing Address - Country:US
Mailing Address - Phone:919-641-7534
Mailing Address - Fax:
Practice Address - Street 1:1424 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-4210
Practice Address - Country:US
Practice Address - Phone:919-332-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)