Provider Demographics
NPI:1427808963
Name:LEE, KENNETHA LASHAYE (CNA)
Entity type:Individual
Prefix:MS
First Name:KENNETHA
Middle Name:LASHAYE
Last Name:LEE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4946 S. LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860
Mailing Address - Country:US
Mailing Address - Phone:813-629-2519
Mailing Address - Fax:
Practice Address - Street 1:4946 S. LAKE DR
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860
Practice Address - Country:US
Practice Address - Phone:813-629-2519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health