Provider Demographics
NPI:1316327729
Name:HARRIS, LAKOSCIA (ARNP)
Entity type:Individual
Prefix:
First Name:LAKOSCIA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:ARNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:521 W STATE ROAD 434 STE 101
Practice Address - Street 2:PEDIATRIC&ADOLESCENT MED OF SEMINOLE, IN ASSOC WITH NEM
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4952
Practice Address - Country:US
Practice Address - Phone:407-830-5437
Practice Address - Fax:407-830-4907
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9193529363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics