Provider Demographics
NPI:1093699761
Name:GILLESPIE, LA'KEIAH M (NCPT, NCMA, LNA)
Entity type:Individual
Prefix:
First Name:LA'KEIAH
Middle Name:M
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:NCPT, NCMA, LNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 SHOPPING PLAZA RD # 134
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-5205
Mailing Address - Country:US
Mailing Address - Phone:802-417-8345
Mailing Address - Fax:
Practice Address - Street 1:53 EAST ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4128
Practice Address - Country:US
Practice Address - Phone:802-417-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL522547246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty