Healthcare Provider Details

I. General information

NPI: 1497306625
Provider Name (Legal Business Name): SHENEAKA SYKES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2019
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 W PIKE ST STE 106
LAWRENCEVILLE GA
30046-3240
US

IV. Provider business mailing address

368 W PIKE ST STE 106
LAWRENCEVILLE GA
30046-3240
US

V. Phone/Fax

Practice location:
  • Phone: 702-941-0874
  • Fax: 470-294-1086
Mailing address:
  • Phone: 702-941-0874
  • Fax: 470-294-1086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN242539
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: