Provider Demographics
NPI:1619661964
Name:LKD ONLINE ENTERPRISES LLC
Entity Type:Organization
Organization Name:LKD ONLINE ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-629-0598
Mailing Address - Street 1:7700 YEARLING WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4336
Mailing Address - Country:US
Mailing Address - Phone:507-629-0598
Mailing Address - Fax:
Practice Address - Street 1:7700 YEARLING WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-4336
Practice Address - Country:US
Practice Address - Phone:507-629-0598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty