Provider Demographics
NPI:1497491658
Name:HARRIS, LASHONDA CAMERON (NP)
Entity Type:Individual
Prefix:MRS
First Name:LASHONDA
Middle Name:CAMERON
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:LASHONDA
Other - Middle Name:CHERRESE
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 POPLAR DR STE C
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9391
Mailing Address - Country:US
Mailing Address - Phone:804-733-5591
Mailing Address - Fax:804-733-3506
Practice Address - Street 1:321 POPLAR DR STE C
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9391
Practice Address - Country:US
Practice Address - Phone:804-733-5591
Practice Address - Fax:804-733-3506
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily