Provider Demographics
NPI:1538058250
Name:FEASTER, MARILYN LASHA
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:LASHA
Last Name:FEASTER
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 1:2284 STATESVILLE BLVD APT 207
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-0010
Mailing Address - Country:US
Mailing Address - Phone:704-743-6957
Mailing Address - Fax:
Practice Address - Street 1:2284 STATESVILLE BLVD APT 207
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-0010
Practice Address - Country:US
Practice Address - Phone:704-743-6957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals