Provider Demographics
NPI:1902495716
Name:PITTS, LAKAYA V (LPN)
Entity Type:Individual
Prefix:MS
First Name:LAKAYA
Middle Name:V
Last Name:PITTS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BUTTERCUP WAY APT 26
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-2577
Mailing Address - Country:US
Mailing Address - Phone:864-202-7632
Mailing Address - Fax:
Practice Address - Street 1:100 BUTTERCUP WAY APT 26
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2577
Practice Address - Country:US
Practice Address - Phone:864-202-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCP40505164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse