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General NPI Number Information
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NPI Number | 1851969281
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Entity Type | Individual
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Provider Name | SHINEQUA WHITE
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Gender | Female
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Dates
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Enumeration Date | 06/13/2021
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Last Update Date | 06/13/2021
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Provider Practice Location Address
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Address Line | 525 N 16TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3319
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Country | US
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Telephone | 870-912-1207
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Fax | 870-912-1208
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Provider Business Mailing Address
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Address Line | 525 N 16TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3319
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Country | US
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Telephone | 870-912-1207
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Fax | 870-912-1208
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | AR5747
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License Number State | AR
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