Provider Demographics
NPI:1679063002
Name:WEBB SPURLOCK, LAKESHA (OWNER)
Entity type:Individual
Prefix:MRS
First Name:LAKESHA
Middle Name:
Last Name:WEBB SPURLOCK
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:LAKESHA
Other - Middle Name:
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15706 FIREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3032
Mailing Address - Country:US
Mailing Address - Phone:225-312-7260
Mailing Address - Fax:
Practice Address - Street 1:15706 FIREWOOD DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3032
Practice Address - Country:US
Practice Address - Phone:225-312-7260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)