Provider Demographics
NPI:1568151769
Name:GOLSTON, LADONNA
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:
Last Name:GOLSTON
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 1:2500 SIERRA BELLO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-1698
Mailing Address - Country:US
Mailing Address - Phone:913-683-9283
Mailing Address - Fax:702-357-8317
Practice Address - Street 1:2500 SIERRA BELLO AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1698
Practice Address - Country:US
Practice Address - Phone:913-683-9283
Practice Address - Fax:702-357-8317
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant