Provider Demographics
NPI:1548500010
Name:BOYKIN-WRIGHT, LAKISHA M (APRN)
Entity type:Individual
Prefix:MRS
First Name:LAKISHA
Middle Name:M
Last Name:BOYKIN-WRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LAKISHA
Other - Middle Name:M
Other - Last Name:BOYKIN WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:1624 MAIN STREET
Mailing Address - Street 2:DBA LTC HEALTH SOLUTIONS
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2818
Mailing Address - Country:US
Mailing Address - Phone:803-726-2350
Mailing Address - Fax:803-753-9102
Practice Address - Street 1:1053 CENTER STREET
Practice Address - Street 2:DBA LTC HEALTH SOLUTIONS
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169
Practice Address - Country:US
Practice Address - Phone:800-491-0909
Practice Address - Fax:843-353-2581
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2424Medicaid
SCNP2424Medicaid