Provider Demographics
NPI:1508561721
Name:MARTIN, LAKESHIA CECILIA
Entity Type:Individual
Prefix:
First Name:LAKESHIA
Middle Name:CECILIA
Last Name:MARTIN
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 1:5134 SHERIFF RD NE APT 304
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5523
Mailing Address - Country:US
Mailing Address - Phone:202-321-7339
Mailing Address - Fax:
Practice Address - Street 1:600 KENILWORTH TER NE APT 417
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1983
Practice Address - Country:US
Practice Address - Phone:240-706-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant