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NPI Code Detail

MEDICARE: MS. LANEISHA ANN DAWKINS APRN, NP-C

MEDICARE: MS. LANEISHA ANN DAWKINS APRN, NP-C
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
1163W00000XRegistered NurseRN162457GA
2363LF0000XFamily Nurse PractitionerRN162457GA

General Provider Information

NPI Number : 1922171503
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LANEISHA ANN DAWKINS APRN, NP-C
Provider Business Mailing Address
First Line : 1075 LAFAYETTE PKWY STE 100
Second Line :
City : LAGRANGE
State : GA
Zip : 30241-3507
Country : US
Telephone Number : 706-443-5273
Fax Number : 762-323-1014
Provider Business Practice Location Address
First Line : 1075 LAFAYETTE PKWY STE 100
Second Line :
City : LAGRANGE
State : GA
Zip : 30241-3507
Country : US
Telephone Number : 706-443-5273
Fax Number : 762-323-1014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 06/16/2022

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