Provider Demographics
NPI:1366789661
Name:HAMBURG, LAKEASHA R BATISTE
Entity type:Individual
Prefix:MRS
First Name:LAKEASHA
Middle Name:R BATISTE
Last Name:HAMBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4417
Mailing Address - Country:US
Mailing Address - Phone:504-715-9469
Mailing Address - Fax:
Practice Address - Street 1:1632 WAKEFIELD DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4417
Practice Address - Country:US
Practice Address - Phone:504-715-9469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45938390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program