Provider Demographics
NPI:1568010130
Name:DEENER, LASHAWN NICOLE
Entity Type:Individual
Prefix:
First Name:LASHAWN
Middle Name:NICOLE
Last Name:DEENER
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 1:1784 W WATERFORD CT APT 1927
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-8505
Mailing Address - Country:US
Mailing Address - Phone:216-450-8858
Mailing Address - Fax:
Practice Address - Street 1:1784 W WATERFORD CT APT 1927
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-8505
Practice Address - Country:US
Practice Address - Phone:216-450-8858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRX970296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse