Provider Demographics
NPI:1639754518
Name:CRITCHLOW, LA'SHEENA
Entity Type:Individual
Prefix:
First Name:LA'SHEENA
Middle Name:
Last Name:CRITCHLOW
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 1:8021 FALCON CREEK CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-1800
Mailing Address - Country:US
Mailing Address - Phone:804-617-2805
Mailing Address - Fax:
Practice Address - Street 1:8021 FALCON CREEK CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-1800
Practice Address - Country:US
Practice Address - Phone:804-617-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001278437163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse