MEDICARE: MS. SHAWNAE CLAXTON LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	0002081765	VA

General Provider Information

NPI Number	:	1225988694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAWNAE CLAXTON LPN

Provider Business Mailing Address
First Line	:	5312 VERLINDA DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23237-3307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2623 PARK AVE
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2420
Country	:	US
Telephone Number	:	804-471-4711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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