Provider Demographics
NPI:1649366212
Name:PINNOCK, LA-KEISHA RENEE (NP)
Entity type:Individual
Prefix:MRS
First Name:LA-KEISHA
Middle Name:RENEE
Last Name:PINNOCK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LA-KEISHA
Other - Middle Name:RENEE
Other - Last Name:MILORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4115
Mailing Address - Country:US
Mailing Address - Phone:781-552-8438
Mailing Address - Fax:
Practice Address - Street 1:99 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4115
Practice Address - Country:US
Practice Address - Phone:781-552-8438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN258012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily