Provider Demographics
NPI:1134832975
Name:FIELDS, LAKEAN MARIE
Entity type:Individual
Prefix:
First Name:LAKEAN
Middle Name:MARIE
Last Name:FIELDS
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 1:5580 BRANCHVILLE DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-1508
Mailing Address - Country:US
Mailing Address - Phone:614-620-7060
Mailing Address - Fax:
Practice Address - Street 1:5580 BRANCHVILLE DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-1508
Practice Address - Country:US
Practice Address - Phone:614-620-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator