Provider Demographics
NPI:1235502980
Name:DAVIS, LAKEISHA SHANTA (RN)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:SHANTA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 SIMON BOLIVAR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-4160
Mailing Address - Country:US
Mailing Address - Phone:504-658-2829
Mailing Address - Fax:504-658-2874
Practice Address - Street 1:2222 SIMON BOLIVAR AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1460
Practice Address - Country:US
Practice Address - Phone:504-658-2829
Practice Address - Fax:504-658-2874
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN114624163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health