Provider Demographics
NPI:1922691799
Name:PASLEY, LAQUETTA
Entity Type:Individual
Prefix:
First Name:LAQUETTA
Middle Name:
Last Name:PASLEY
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 1:226 59TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35064-2028
Mailing Address - Country:US
Mailing Address - Phone:205-821-1589
Mailing Address - Fax:
Practice Address - Street 1:226 59TH ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:AL
Practice Address - Zip Code:35064-2028
Practice Address - Country:US
Practice Address - Phone:205-821-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7958154172A00000X
372500000X, 374U00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore Provider
No374U00000XNursing Service Related ProvidersHome Health Aide