Provider Demographics
NPI:1891926770
Name:WHITE, LA'SHAWN L
Entity Type:Individual
Prefix:MRS
First Name:LA'SHAWN
Middle Name:L
Last Name:WHITE
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 1:10698 CHELMSFORD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3910
Mailing Address - Country:US
Mailing Address - Phone:513-522-0235
Mailing Address - Fax:
Practice Address - Street 1:10698 CHELMSFORD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3910
Practice Address - Country:US
Practice Address - Phone:513-522-0235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN130003164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse