Provider Demographics
NPI:1972840056
Name:ROLAND, LASHANDRA (LPN)
Entity Type:Individual
Prefix:
First Name:LASHANDRA
Middle Name:
Last Name:ROLAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 KEUKA RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-4306
Mailing Address - Country:US
Mailing Address - Phone:516-263-8529
Mailing Address - Fax:
Practice Address - Street 1:1049 KEUKA RD
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-4306
Practice Address - Country:US
Practice Address - Phone:516-263-8529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268744164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse