Active NPI
Lanisha Antoinette Blevins, NURSE
- Licensed Practical Nurse
- Inkster, MI
National Provider Identifier
1891399705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 1492119
- Practice address
- 1574 W River Park Dr
Inkster, MI 48141-1836 - Phone
- (313) 758-8362
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 1492119 | MI | Primary |
Addresses
Primary practice location
1574 W River Park Dr
Inkster, MI 48141-1836
Mailing address
1574 W River Park Dr
Inkster, MI 48141-1836
Phone (313) 758-8362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1492119 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1891399705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1574 W RIVER PARK DR",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411836",
"telephone_number": "313-758-8362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1574 W RIVER PARK DR",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411836",
"telephone_number": "313-758-8362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEVINS",
"first_name": "LANISHA",
"middle_name": "ANTOINETTE",
"name_prefix": "Miss",
"credential": "NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-23",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "1492119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Inkster, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.