Provider Demographics
NPI:1891237889
Name:SHEAFFER, LAKIESHA (NP)
Entity type:Individual
Prefix:
First Name:LAKIESHA
Middle Name:
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5207
Mailing Address - Country:US
Mailing Address - Phone:541-414-0481
Mailing Address - Fax:541-414-0482
Practice Address - Street 1:1745 DRAGON TAIL PL
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7290
Practice Address - Country:US
Practice Address - Phone:850-867-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201608321NP-PP363LF0000X
FLAPRN9494253363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily