La'Shon Thedford, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

4703104399 Issued in MI

Practice address

62 Northbound Gratiot Ave
Mount Clemens, MI 48043-2310

Phone

(586) 468-8983

NPI assigned

Nov 12, 2014

Last updated

Nov 13, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1750787164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 NORTHBOUND GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 NORTHBOUND GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432310",
            "telephone_number": "586-468-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEDFORD",
        "first_name": "LA'SHON",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "MI",
            "license": "4703104399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Licensed Vocational Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.