Provider Demographics
NPI:1710585641
Name:FLOOD, LAKISA R
Entity Type:Individual
Prefix:
First Name:LAKISA
Middle Name:R
Last Name:FLOOD
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 1:8464 FIELDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4779
Mailing Address - Country:US
Mailing Address - Phone:240-559-6310
Mailing Address - Fax:
Practice Address - Street 1:8464 FIELDSTONE WAY
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4779
Practice Address - Country:US
Practice Address - Phone:240-559-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty