Provider Demographics
NPI:1881470151
Name:MCRAE, LASHAWNA T (RN)
Entity type:Individual
Prefix:
First Name:LASHAWNA
Middle Name:T
Last Name:MCRAE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 ARBOR GREENE DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7136
Mailing Address - Country:US
Mailing Address - Phone:919-817-0527
Mailing Address - Fax:
Practice Address - Street 1:1116 ARBOR GREENE DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7136
Practice Address - Country:US
Practice Address - Phone:919-817-0527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC217086163WD1100X, 163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Multi-Specialty
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC217086OtherRN