Provider Demographics
NPI:1528766987
Name:LIFHRED, LASHANDA (DOULA)
Entity type:Individual
Prefix:
First Name:LASHANDA
Middle Name:
Last Name:LIFHRED
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GRAND CLUB PL
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-8129
Mailing Address - Country:US
Mailing Address - Phone:772-979-3131
Mailing Address - Fax:
Practice Address - Street 1:805 GRAND CLUB PL
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-8129
Practice Address - Country:US
Practice Address - Phone:772-979-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374J00000XOtherDOULA