Healthcare Provider Details

I. General information

NPI: 1245095397
Provider Name (Legal Business Name): LEKEISHA FIFFIE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 02/19/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 BLOUNT RD
POMPANO BEACH FL
33069-1118
US

IV. Provider business mailing address

311 NE 26TH ST
POMPANO BEACH FL
33064-4543
US

V. Phone/Fax

Practice location:
  • Phone: 954-831-3541
  • Fax:
Mailing address:
  • Phone: 954-709-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number11031330
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: