Provider Demographics
NPI:1245598523
Name:STONE, LASHUNDA NICOLE (NP-C)
Entity Type:Individual
Prefix:
First Name:LASHUNDA
Middle Name:NICOLE
Last Name:STONE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 ISABELLA ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-3942
Mailing Address - Country:US
Mailing Address - Phone:912-550-9308
Mailing Address - Fax:
Practice Address - Street 1:505 CITY BLVD
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-8003
Practice Address - Country:US
Practice Address - Phone:912-490-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN199952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily