Provider Demographics
NPI:1598128134
Name:JOSEPH, LAWANDA (LPN)
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807-5660
Mailing Address - Country:US
Mailing Address - Phone:225-663-0288
Mailing Address - Fax:
Practice Address - Street 1:2445 79TH AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807-5660
Practice Address - Country:US
Practice Address - Phone:225-663-0288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA290099164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse