Provider Demographics
NPI:1922736644
Name:MAXWELL, LAKEISHA NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:NICOLE
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 TOLEDO TER APT 448
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3264
Mailing Address - Country:US
Mailing Address - Phone:202-713-3422
Mailing Address - Fax:
Practice Address - Street 1:2720 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2601
Practice Address - Country:US
Practice Address - Phone:202-713-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1044567163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency