Provider Demographics
NPI:1669290045
Name:HUTCHINSON, LAKISHA JOY
Entity type:Individual
Prefix:
First Name:LAKISHA
Middle Name:JOY
Last Name:HUTCHINSON
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 1:3550 TREMONT DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-3057
Mailing Address - Country:US
Mailing Address - Phone:314-814-0278
Mailing Address - Fax:
Practice Address - Street 1:3550 TREMONT DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-3057
Practice Address - Country:US
Practice Address - Phone:314-814-0278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health