Provider Demographics
NPI:1902449515
Name:GRIER, LASHAWNDA M
Entity Type:Individual
Prefix:
First Name:LASHAWNDA
Middle Name:M
Last Name:GRIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4058 CHEDWORTH WAY # GA
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-5461
Mailing Address - Country:US
Mailing Address - Phone:216-212-5270
Mailing Address - Fax:
Practice Address - Street 1:4058 CHEDWORTH WAY # GA
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-5461
Practice Address - Country:US
Practice Address - Phone:216-212-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400045381101376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH400045381101OtherNURSING ASSISTANT