Provider Demographics
NPI:1720459779
Name:MORROW, LAWANDA LAKISHA (LPN)
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:LAKISHA
Last Name:MORROW
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LAWANDA
Other - Middle Name:LAKISHA
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:777 E NAPIER AVE APT C3
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-6128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:777 E NAPIER AVE APT C3
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-6128
Practice Address - Country:US
Practice Address - Phone:269-252-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703105064164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse