Provider Demographics
NPI:1699143347
Name:HIGH, LAKESHA WANTA (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LAKESHA
Middle Name:WANTA
Last Name:HIGH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LAKESHA
Other - Middle Name:TULLIS
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2737 WARM SPRINGS RD STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5328
Mailing Address - Country:US
Mailing Address - Phone:706-653-2255
Mailing Address - Fax:
Practice Address - Street 1:2737 WARM SPRINGS RD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5328
Practice Address - Country:US
Practice Address - Phone:706-653-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN193416363LF0000X
AL1-144132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily