Provider Demographics
NPI:1184206484
Name:LAFAYETTE, NASHONDA RENEE (NP)
Entity Type:Individual
Prefix:MS
First Name:NASHONDA
Middle Name:RENEE
Last Name:LAFAYETTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-2128
Mailing Address - Country:US
Mailing Address - Phone:267-275-1438
Mailing Address - Fax:
Practice Address - Street 1:1101 W MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-1639
Practice Address - Country:US
Practice Address - Phone:508-365-2124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023281363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily