Individual
LAKETA BUMPERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6118 SAINT GILES ST STE 130, RALEIGH, NC 27612-7099
(919) 910-0800
Mailing address
6118 SAINT GILES ST STE 130, RALEIGH, NC 27612-7099
(919) 910-0800
(919) 341-5068
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
88922
NC
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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