Individual
MS. LAKEISHA JEANECE STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5471 DR MARTIN LUTHER KING DRIVE, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DRIVE, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2006037203
MO
Other
Enumeration date
04/30/2007
Last updated
07/08/2007
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