Healthcare Provider Details

I. General information

NPI: 1700253200
Provider Name (Legal Business Name): LAKISHA HASKINS-SCOTT RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAKISHA C HASKINS

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4504 WOLF RUN DR
GREENSBORO NC
27406-8097
US

IV. Provider business mailing address

4504 WOLF RUN DR
GREENSBORO NC
27406-8097
US

V. Phone/Fax

Practice location:
  • Phone: 434-944-1935
  • Fax:
Mailing address:
  • Phone: 434-944-1935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number263617
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: