Provider Demographics
NPI:1730777954
Name:SMITH, LASHANE RAMONA
Entity type:Individual
Prefix:MRS
First Name:LASHANE
Middle Name:RAMONA
Last Name:SMITH
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 1:606 MCDONALD DR APT C2
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-5302
Mailing Address - Country:US
Mailing Address - Phone:601-278-4773
Mailing Address - Fax:
Practice Address - Street 1:606 MCDONALD DR APT C2
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5302
Practice Address - Country:US
Practice Address - Phone:601-278-4773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS914319163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS914319OtherMS BOARD OF NURSING LICENSE