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NPI 1457124851

NPI 1457124851 : SHAMEKA HARRIS LPN : MEMPHIS, TN

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General NPI Number Information
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    NPI Number           |    1457124851
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    Entity Type          |    Individual 
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    Provider Name        |    SHAMEKA HARRIS LPN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/07/2023
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    Last Update Date     |    11/07/2023
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Provider Practice Location Address
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    Address Line         |    1490 MONROE AVE 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38104-3757
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    Country              |    US
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    Telephone            |    901-571-6108
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 34011 
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    City                 |    MEMPHIS
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    State                |    TN
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    Zip                  |    38184-0011
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    Country              |    US
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    Telephone            |    
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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        |    164W00000X
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    Taxonomy Name        |    Licensed Practical Nurse
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    License Number       |    66700
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    License Number State |    TN
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