Healthcare Provider Details

I. General information

NPI: 1528474632
Provider Name (Legal Business Name): LA'KEISHA COKER MS,RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E. CHEVES ST. FLORENCE COUNTY HEALTH DEPARTMENT
FLORENCE SC
29506
US

IV. Provider business mailing address

145 E. CHEVES ST. FLORENCE COUNTY HEALTH DEPARTMENT
FLORENCE SC
29506
US

V. Phone/Fax

Practice location:
  • Phone: 843-661-4835
  • Fax: 843-661-4844
Mailing address:
  • Phone: 843-661-4835
  • Fax: 843-661-4844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number997
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: