Provider Demographics
NPI:1750830535
Name:CLOUD, LAKIESHA D (PHLEBOTOMIST TECH)
Entity Type:Individual
Prefix:
First Name:LAKIESHA
Middle Name:D
Last Name:CLOUD
Suffix:
Gender:F
Credentials:PHLEBOTOMIST TECH
Other - Prefix:
Other - First Name:LAKIESHA
Other - Middle Name:D
Other - Last Name:CLOUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MEDICAL ASSISTANT
Mailing Address - Street 1:4483 LINDSEY DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-3413
Mailing Address - Country:US
Mailing Address - Phone:678-210-1745
Mailing Address - Fax:678-868-1715
Practice Address - Street 1:4483 LINDSEY DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-3413
Practice Address - Country:US
Practice Address - Phone:678-210-1745
Practice Address - Fax:678-868-1715
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No374700000XNursing Service Related ProvidersTechnician