Provider Demographics
NPI:1396240982
Name:LANSING, SASHA M (RN, CLC)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:M
Last Name:LANSING
Suffix:
Gender:F
Credentials:RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 NW 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6267
Mailing Address - Country:US
Mailing Address - Phone:561-929-8426
Mailing Address - Fax:
Practice Address - Street 1:2402 NW 31ST ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6267
Practice Address - Country:US
Practice Address - Phone:561-929-8426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9293707163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant