Provider Demographics
NPI:1922811314
Name:AHMED, LETASHA L
Entity type:Individual
Prefix:
First Name:LETASHA
Middle Name:L
Last Name:AHMED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LETASHA
Other - Middle Name:L
Other - Last Name:SOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 11TH AVE W APT 2
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4733
Mailing Address - Country:US
Mailing Address - Phone:424-944-0216
Mailing Address - Fax:
Practice Address - Street 1:305 11TH AVE W APT 2
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4733
Practice Address - Country:US
Practice Address - Phone:424-944-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND85608374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide