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General NPI Number Information
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NPI Number | 1093298523
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Entity Type | Individual
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Provider Name | SHANADRA GAYDEN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2101 MILL RD APT 109
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City | ALEXANDRIA
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State | VA
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Zip | 22314-5318
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Country | US
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Telephone | 240-899-2753
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 MILL RD
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City | ALEXANDRIA
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State | VA
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Zip | 22314-5317
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Country | US
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Telephone | 240-899-2753
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 1401229089
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License Number State | VA
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