Individual
MRS. LAKESHA QUIANA HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
928 BROWN STREET, GULFPORT, MS 39507-3758
(414) 517-1033
Mailing address
928 BROWN STREET, GULFPORT, MS 39507-3758
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
309925-31
WI
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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