Provider Demographics
NPI:1669007563
Name:WOFFORD, LASHONDA RENEE
Entity Type:Individual
Prefix:MRS
First Name:LASHONDA
Middle Name:RENEE
Last Name:WOFFORD
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 1:5405 QUARTER POLE LN
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-8355
Mailing Address - Country:US
Mailing Address - Phone:910-568-5319
Mailing Address - Fax:910-491-9719
Practice Address - Street 1:5405 QUARTER POLE LN
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-8355
Practice Address - Country:US
Practice Address - Phone:910-568-5319
Practice Address - Fax:910-491-9719
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NCHC5389251J00000X, 251S00000X, 253Z00000X, 376J00000X, 376K00000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care