Individual
LAKISHA STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
42 SHANNON CT, MACON, MS 39341-2665
(662) 708-1645
Mailing address
42 SHANNON CT, MACON, MS 39341-2665
(662) 708-1645
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906209
MS
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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