Provider Demographics
NPI:1730390774
Name:DUNN, LAKISHA R (MPA)
Entity type:Individual
Prefix:MS
First Name:LAKISHA
Middle Name:R
Last Name:DUNN
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 EASTBROOK LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-4335
Mailing Address - Country:US
Mailing Address - Phone:706-329-1926
Mailing Address - Fax:
Practice Address - Street 1:5475 EASTBROOK LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-4335
Practice Address - Country:US
Practice Address - Phone:706-329-1926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor