Individual ProviderLashanna R SpanCase Manager/Care CoordinatorOther Service ProvidersPractice Address209 S Lockard St, Blytheville, AR 72315-2541(870) 763-2139PECOS EnrollmentBased on the most recent information from CMS, provider Lashanna R Span does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1750967394Provider TypeIndividualFull NameSpan, Lashanna RGenderFemaleSole ProprietorNoEnumeration Date3/23/2021Last Updated3/23/2021Contact InformationPractice LocationPractice Address209 S Lockard St, Blytheville, AR 72315-2541Phone(870) 763-2139FaxUnlisted FaxMailing LocationMailing Address209 S Lockard St, Blytheville, AR 72315-2541Phone(870) 763-2139FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer