Provider Demographics
NPI:1841941176
Name:GASKINS, SHAVAUGHN LAKEIA
Entity type:Individual
Prefix:MS
First Name:SHAVAUGHN
Middle Name:LAKEIA
Last Name:GASKINS
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 1:1521 OLIVE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2716
Mailing Address - Country:US
Mailing Address - Phone:202-641-4144
Mailing Address - Fax:
Practice Address - Street 1:810 49TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4819
Practice Address - Country:US
Practice Address - Phone:202-399-6427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider