Provider Demographics
NPI:1548997463
Name:CARROLL, LASHUNDA (CNA)
Entity type:Individual
Prefix:
First Name:LASHUNDA
Middle Name:
Last Name:CARROLL
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 1:1885 HARPER DR APT 27A
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3839
Mailing Address - Country:US
Mailing Address - Phone:678-822-8694
Mailing Address - Fax:
Practice Address - Street 1:1885 HARPER DR APT 27A
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-3839
Practice Address - Country:US
Practice Address - Phone:678-822-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0000048072376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide