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NPI Code Detail

MEDICARE: MRS. LASHONDA NABORS

MEDICARE:  MRS. LASHONDA  NABORS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideLC9784119MO

General Provider Information

NPI Number : 1053847756
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LASHONDA NABORS
Provider Business Mailing Address
First Line : 4354 WEST MAFFITT AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113
Country : US
Telephone Number : 314-803-1857
Fax Number :
Provider Business Practice Location Address
First Line : 4354 W MAFFITT AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63113-2523
Country : US
Telephone Number : 314-803-1857
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2017
Last Update Date : 05/02/2017

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Directions to “ MRS. LASHONDA NABORS ” Practice Location

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