Provider Demographics
NPI:1275203408
Name:BAILEY, LASHANDRIA (LPN)
Entity Type:Individual
Prefix:
First Name:LASHANDRIA
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LASHANDRIA
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4909 PARK SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6171
Mailing Address - Country:US
Mailing Address - Phone:504-333-1739
Mailing Address - Fax:
Practice Address - Street 1:4909 PARK SHORE DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-6171
Practice Address - Country:US
Practice Address - Phone:504-333-1739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-18
Last Update Date:2021-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA20130131164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse