Provider Demographics
NPI:1396410858
Name:HORTON, LASHAUN MARIE (CNA)
Entity Type:Individual
Prefix:MS
First Name:LASHAUN
Middle Name:MARIE
Last Name:HORTON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 HIGHLAND AVE S APT 604
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-3834
Mailing Address - Country:US
Mailing Address - Phone:205-720-4987
Mailing Address - Fax:
Practice Address - Street 1:2040 HIGHLAND AVE S APT 604
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3834
Practice Address - Country:US
Practice Address - Phone:205-720-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL314000000X, 374U00000X, 385H00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No374U00000XNursing Service Related ProvidersHome Health Aide
No385H00000XRespite Care FacilityRespite Care