Provider Demographics
NPI:1295128775
Name:TOOLE, LAVEISHA
Entity type:Individual
Prefix:
First Name:LAVEISHA
Middle Name:
Last Name:TOOLE
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 1:10887 HIGHWAY 494
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-9733
Mailing Address - Country:US
Mailing Address - Phone:601-938-7691
Mailing Address - Fax:
Practice Address - Street 1:10887 HIGHWAY 494
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-9733
Practice Address - Country:US
Practice Address - Phone:601-938-7691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide