Individual
LAKEYA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
417 LIBERTY ST, SPRINGFIELD, MA 01104-3736
(413) 733-7875
Mailing address
245 STAPLETON RD, SPRINGFIELD, MA 01109-1525
(413) 886-3024
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN1000963
MA
Other
Enumeration date
05/31/2025
Last updated
05/31/2025
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