| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LAKETA MCCORMICK | 1417734757 | 2023-09-11 |
Laketa Mccormick is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417734757. Registration indicates Laketa Mccormick is a provider of services with a specialization in Nursing Service Related Providers, Adult Companion (Adult Companion, ) (Adult Companion, Nursing Service Related Providers)
| Entity Type | Individual |
| Provider Name | Laketa Mccormick |
| Practice Office Address | 7 WINCHESTER RD KINGSTREE, SC US |
| Practice Office Telephone | 8039774652 |
| Mailing Address | 7 WINCHESTER RD KINGSTREE, SC 295565772 US |
| Code | Practice | License No State |
|---|---|---|
| 372600000X PRIMARY | Nursing Service Related Providers Adult Companion Adult Companion Adult Companion Nursing Service Related Providers |
| 1588345383 | MEDICAID | SC |