Provider Demographics
NPI:1922821933
Name:WILLIAMS, LASANDRA
Entity type:Individual
Prefix:
First Name:LASANDRA
Middle Name:
Last Name:WILLIAMS
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 1:1233 HAMMOND DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5111
Mailing Address - Country:US
Mailing Address - Phone:910-405-4280
Mailing Address - Fax:
Practice Address - Street 1:420 FAIRLY ST STE B
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3612
Practice Address - Country:US
Practice Address - Phone:910-405-4280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula