Provider Demographics
NPI:1821455734
Name:ECHOLES, LAJAYSHA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAJAYSHA
Middle Name:
Last Name:ECHOLES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 N LAMAR BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2861
Mailing Address - Country:US
Mailing Address - Phone:662-238-7871
Mailing Address - Fax:662-238-7871
Practice Address - Street 1:1109 N LAMAR BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-2861
Practice Address - Country:US
Practice Address - Phone:662-238-7871
Practice Address - Fax:662-238-7871
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2015022264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily