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General NPI Number Information
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NPI Number | 1548997463
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Entity Type | Individual
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Provider Name | LASHUNDA CARROLL CNA
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Gender | Female
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 1885 HARPER DR APT 27A
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City | MORROW
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State | GA
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Zip | 30260-3839
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Country | US
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Telephone | 678-822-8694
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Fax |
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Provider Business Mailing Address
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Address Line | 1885 HARPER DR APT 27A
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City | MORROW
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State | GA
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Zip | 30260-3839
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Country | US
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Telephone | 678-822-8694
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CN0000048072
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License Number State | GA
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