Healthcare Provider Details

I. General information

NPI: 1255182168
Provider Name (Legal Business Name): TOMEKA LASHUN MCDONALD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TOMEKA LASHUN STANFORD FNP

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5600
  • Fax:
Mailing address:
  • Phone: 843-228-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN279486
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: