Provider Demographics
NPI:1891194148
Name:ASHE, LAKETHA
Entity Type:Individual
Prefix:
First Name:LAKETHA
Middle Name:
Last Name:ASHE
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 1:2608 BROADMOOR DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31903-3520
Mailing Address - Country:US
Mailing Address - Phone:334-855-4900
Mailing Address - Fax:334-384-9172
Practice Address - Street 1:2608 BROADMOOR DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-3520
Practice Address - Country:US
Practice Address - Phone:334-855-4900
Practice Address - Fax:334-384-9172
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89102-0701246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy