Healthcare Provider Details

I. General information

NPI: 1124963285
Provider Name (Legal Business Name): SHAKERIA MONICA SELLARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7477 NORTHSIDE DR # 214
NORTH CHARLESTON SC
29420-4209
US

IV. Provider business mailing address

7477 NORTHSIDE DR APT 214
NORTH CHARLESTON SC
29420-4209
US

V. Phone/Fax

Practice location:
  • Phone: 472-234-9702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number9993704
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: