Healthcare Provider Details

I. General information

NPI: 1326554676
Provider Name (Legal Business Name): LASHICCA CARMICHAEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2017
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 15222
PANAMA CITY FL
32406-5222
US

IV. Provider business mailing address

PO BOX 15222
PANAMA CITY FL
32406-5222
US

V. Phone/Fax

Practice location:
  • Phone: 850-740-9516
  • Fax:
Mailing address:
  • Phone: 850-740-9516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: