Provider Demographics
NPI:1790176493
Name:EKEOCHA, LASTESHIA NICOLE (MSN, WHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LASTESHIA
Middle Name:NICOLE
Last Name:EKEOCHA
Suffix:
Gender:F
Credentials:MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 ELAM RD
Mailing Address - Street 2:WOMEN'S HEALTH CENTER
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-4151
Mailing Address - Country:US
Mailing Address - Phone:214-266-1000
Mailing Address - Fax:214-266-1790
Practice Address - Street 1:9202 ELAM RD
Practice Address - Street 2:WOMEN'S HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4151
Practice Address - Country:US
Practice Address - Phone:214-266-1000
Practice Address - Fax:214-266-1790
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127117363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health