Provider Demographics
NPI:1497641930
Name:WIMBISH, LASHANDA
Entity type:Individual
Prefix:
First Name:LASHANDA
Middle Name:
Last Name:WIMBISH
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 1:1355 HERBERT COLLINS WAY
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-3167
Mailing Address - Country:US
Mailing Address - Phone:347-566-0384
Mailing Address - Fax:
Practice Address - Street 1:1355 HERBERT COLLINS WAY
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-3167
Practice Address - Country:US
Practice Address - Phone:347-566-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty