Provider Demographics
NPI:1578205613
Name:GAITER, LASHANDA (CNA)
Entity type:Individual
Prefix:
First Name:LASHANDA
Middle Name:
Last Name:GAITER
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 1:7309 S HONORE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-3702
Mailing Address - Country:US
Mailing Address - Phone:773-349-1792
Mailing Address - Fax:
Practice Address - Street 1:7309 S HONORE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-3702
Practice Address - Country:US
Practice Address - Phone:773-349-1792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide