Provider Demographics
NPI:1992193684
Name:MAY, LASHANDIA KING
Entity Type:Individual
Prefix:
First Name:LASHANDIA
Middle Name:KING
Last Name:MAY
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 1:4085 TYNDEL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-7474
Mailing Address - Country:US
Mailing Address - Phone:904-717-0031
Mailing Address - Fax:904-717-0037
Practice Address - Street 1:1912 HAMILTON ST STE 205
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2078
Practice Address - Country:US
Practice Address - Phone:904-717-0031
Practice Address - Fax:904-717-0037
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9398370363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily