Provider Demographics
NPI:1306711817
Name:LAKEW, HENOK
Entity type:Individual
Prefix:
First Name:HENOK
Middle Name:
Last Name:LAKEW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5428 ALPINE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-4518
Mailing Address - Country:US
Mailing Address - Phone:704-763-1272
Mailing Address - Fax:
Practice Address - Street 1:5428 ALPINE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-4518
Practice Address - Country:US
Practice Address - Phone:704-763-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care