Provider Demographics
NPI:1194417790
Name:ROLLINS, LAKEISHA
Entity type:Individual
Prefix:MS
First Name:LAKEISHA
Middle Name:
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KHADIJAH
Other - Middle Name:
Other - Last Name:TALIB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2025 FENDALL ST SE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4862
Mailing Address - Country:US
Mailing Address - Phone:602-576-2061
Mailing Address - Fax:
Practice Address - Street 1:2025 FENDALL ST SE UNIT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4862
Practice Address - Country:US
Practice Address - Phone:602-576-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant