Provider Demographics
NPI:1497568992
Name:MEGGINSON, LAQUAYLA LAVONNE
Entity type:Individual
Prefix:
First Name:LAQUAYLA
Middle Name:LAVONNE
Last Name:MEGGINSON
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 1:35 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-6203
Mailing Address - Country:US
Mailing Address - Phone:407-731-4733
Mailing Address - Fax:
Practice Address - Street 1:35 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6203
Practice Address - Country:US
Practice Address - Phone:407-731-4733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant