Provider Demographics
NPI:1518325737
Name:ROWE, LAKEESHA COMEICE (309069-31)
Entity Type:Individual
Prefix:
First Name:LAKEESHA
Middle Name:COMEICE
Last Name:ROWE
Suffix:
Gender:F
Credentials:309069-31
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 W CHAMBERS ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1329
Mailing Address - Country:US
Mailing Address - Phone:414-517-0927
Mailing Address - Fax:
Practice Address - Street 1:6620 W CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1329
Practice Address - Country:US
Practice Address - Phone:414-517-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI309069-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse