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General NPI Number Information
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NPI Number | 1700130036
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Entity Type | Individual
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Provider Name | LAKEYSHIA FIELDS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | BAACH, 121ST CSH/USAMEDDAC-K UNIT # 15244
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City | APO
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State | AP
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Zip | 96205
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Country | US
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Telephone | 315-737-1751
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Fax |
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Provider Business Mailing Address
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Address Line | A CO CSH UNIT 15244 BOX 425
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City | APO
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State | AP
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Zip | 96205
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Country | US
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Telephone | 315-737-1751
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 0001207424
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License Number State | VA
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