Provider Demographics
NPI:1821599986
Name:DAVIS, LEKISHER LASHONE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:LEKISHER
Middle Name:LASHONE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13915 BURNET RD STE 303
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-6505
Mailing Address - Country:US
Mailing Address - Phone:512-996-9559
Mailing Address - Fax:
Practice Address - Street 1:2607 ANDRES WAY
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5712
Practice Address - Country:US
Practice Address - Phone:512-743-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170921164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse