Individual
LAKISHA NASHUN BENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1001 N PALESTINE ST, ATHENS, TX 75751-4122
(903) 535-9041
(903) 904-5085
Mailing address
523 S FANNIN AVE, TYLER, TX 75702-8204
(903) 535-9041
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1062351
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
1062351
TX
Other
Enumeration date
03/24/2022
Last updated
05/13/2025
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