Provider Demographics
NPI:1316183809
Name:LEWIS, LASHAWNA SHIRRELLE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:LASHAWNA
Middle Name:SHIRRELLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 S HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6102
Mailing Address - Country:US
Mailing Address - Phone:419-535-3106
Mailing Address - Fax:
Practice Address - Street 1:405 S HAVEN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6102
Practice Address - Country:US
Practice Address - Phone:419-535-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 129600164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse