Provider Demographics
NPI:1497033906
Name:WALSH-PHILLIPS, LASHAWN DANIELLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LASHAWN
Middle Name:DANIELLE
Last Name:WALSH-PHILLIPS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5606
Mailing Address - Country:US
Mailing Address - Phone:414-507-8612
Mailing Address - Fax:
Practice Address - Street 1:5023 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5606
Practice Address - Country:US
Practice Address - Phone:414-507-8612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI177796-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse