Provider Demographics
NPI:1780288001
Name:SINGLETON, LACRECIA (PARAMEDIC)
Entity type:Individual
Prefix:MS
First Name:LACRECIA
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 SAVANNAH CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-7288
Mailing Address - Country:US
Mailing Address - Phone:601-829-8821
Mailing Address - Fax:
Practice Address - Street 1:26 SAVANNAH CIR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-7288
Practice Address - Country:US
Practice Address - Phone:601-829-8821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-27
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM5039372146L00000X
MS3536372224ZR0403X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS85-4051433OtherIRS