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General NPI Number Information
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NPI Number | 1063791077
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Entity Type | Individual
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Provider Name | SHAMEKIA ANN NWAFOR O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 3810 NE EVANGELINE TRWY
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City | CARENCRO
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State | LA
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Zip | 70520-5966
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Country | US
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Telephone | 337-520-3009
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Fax | 337-896-9698
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Provider Business Mailing Address
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Address Line | 1012 CLINE DR
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-7625
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Country | US
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Telephone | 337-781-5771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1620-653T
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License Number State | LA
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