Provider Demographics
NPI:1578127197
Name:LIGE, LAKISHA M (CNA)
Entity Type:Individual
Prefix:
First Name:LAKISHA
Middle Name:M
Last Name:LIGE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9267 ARTESIAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-1703
Mailing Address - Country:US
Mailing Address - Phone:313-492-1879
Mailing Address - Fax:
Practice Address - Street 1:9267 ARTESIAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1703
Practice Address - Country:US
Practice Address - Phone:313-492-1879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI000038733376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide