Provider Demographics
NPI:1538822978
Name:KEY, DINA LASHAWN
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:LASHAWN
Last Name:KEY
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:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:SC
Mailing Address - Zip Code:29831-0232
Mailing Address - Country:US
Mailing Address - Phone:803-226-5735
Mailing Address - Fax:
Practice Address - Street 1:239 CELESTE AVE
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-2806
Practice Address - Country:US
Practice Address - Phone:803-426-1067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider