Provider Demographics
NPI:1689267775
Name:LANHAM, STESHA KAY
Entity Type:Individual
Prefix:
First Name:STESHA
Middle Name:KAY
Last Name:LANHAM
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 1:159 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:EAST BANK
Mailing Address - State:WV
Mailing Address - Zip Code:25067
Mailing Address - Country:US
Mailing Address - Phone:304-993-3421
Mailing Address - Fax:
Practice Address - Street 1:159 WILLOW ST
Practice Address - Street 2:
Practice Address - City:EAST BANK
Practice Address - State:WV
Practice Address - Zip Code:25067
Practice Address - Country:US
Practice Address - Phone:304-993-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant