Provider Demographics
NPI:1053290122
Name:WATKINS, LASHANTE DIANNE (CNA)
Entity type:Individual
Prefix:MISS
First Name:LASHANTE
Middle Name:DIANNE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 ROUTE 168 FL 1
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1485
Mailing Address - Country:US
Mailing Address - Phone:856-239-1211
Mailing Address - Fax:
Practice Address - Street 1:610 ROUTE 168 FL 1
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-1485
Practice Address - Country:US
Practice Address - Phone:856-239-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNA200025839376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty