Basic Information
Provider Information
NPI: 1477829547
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCADOO
FirstName: LEKESHA
MiddleName: D.
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GRIFFIN
OtherFirstName: LEKESHA
OtherMiddleName: D.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6119 MIDTOWN AVE
Address2: SUITE 201
City: LITTLE ROCK
State: AR
PostalCode: 722055313
CountryCode: US
TelephoneNumber: 5016644532
FaxNumber: 5016634335
Practice Location
Address1: 6119 MIDTOWN AVE
Address2: SUITE 201
City: LITTLE ROCK
State: AR
PostalCode: 722055313
CountryCode: US
TelephoneNumber: 5016644532
FaxNumber: 5016634335
Other Information
ProviderEnumerationDate: 03/22/2012
LastUpdateDate: 06/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XC002905ARY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 
163W00000XR083760ARN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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