Individual
LAKISHA WALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
13101 ALLEN RD BLDG 4, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
13101 ALLEN RD BLDG 4, SOUTHGATE, MI 48195-2216
(734) 785-7700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704290455
MI
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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