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General NPI Number Information
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NPI Number | 1114418183
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Entity Type | Individual
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Provider Name | SHENIKA CHERELLE SMITH
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Gender | Female
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 11 S 12TH ST STE 306
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City | RICHMOND
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State | VA
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Zip | 23219-4282
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Country | US
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Telephone | 804-396-0706
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Fax | 757-210-3907
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Provider Business Mailing Address
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Address Line | 440 MONTICELLO AVE STE 1848
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City | NORFOLK
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State | VA
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Zip | 23510-2571
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Country | US
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Telephone | 757-955-8421
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Fax | 757-210-3907
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO0002123
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 1234873
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License Number State | VA
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