LAKIESHA BOHANNON PA NPI 1255889853

NPI Information

NPI: 1255889853
Provider Name: LAKIESHA BOHANNON, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
3600 SHIRE BLVD STE 104
RICHARDSON, TX
ZIP 75082
Phone: (972) 487-6400
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Lakiesha Bohannon, PA is a surgical physician assistant in Richardson, TX with 4 years of experience. Lakiesha Bohannon, PA NPI is 1255889853. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3600 SHIRE BLVD STE 104
RICHARDSON, TX
ZIP 75082-236
Phone: (972) 487-6400

The NPI 1255889853 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/13/2016 and was last updated on 8/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA13729	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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