Provider Demographics
NPI:1326534967
Name:GARMON, LAWANDER LAKESHA
Entity Type:Individual
Prefix:
First Name:LAWANDER
Middle Name:LAKESHA
Last Name:GARMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:WHISTLER
Mailing Address - State:AL
Mailing Address - Zip Code:36612-1515
Mailing Address - Country:US
Mailing Address - Phone:251-303-9062
Mailing Address - Fax:
Practice Address - Street 1:2841 WARREN ST
Practice Address - Street 2:
Practice Address - City:WHISTLER
Practice Address - State:AL
Practice Address - Zip Code:36612-1515
Practice Address - Country:US
Practice Address - Phone:251-303-9062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6213993747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant