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NPI Code Detail

MEDICARE: MISS SHAMEKA YVONNE TIME RN

MEDICARE: MISS SHAMEKA YVONNE TIME RN
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
1163W00000XRegistered Nurse9510631FL
2363LF0000XFamily Nurse PractitionerAPRN11031605FL

General Provider Information

NPI Number : 1558957100
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SHAMEKA YVONNE TIME RN
Provider Business Mailing Address
First Line : PO BOX 734951
Second Line :
City : CHICAGO
State : IL
Zip : 60673-4951
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 10330 NUVISTA AVE
Second Line :
City : WELLINGTON
State : FL
Zip : 33414-9365
Country : US
Telephone Number : 872-231-3162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2020
Last Update Date : 12/16/2025

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