MEDICARE: MISS SHANIQUA CHARISSE HUNTER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	603437	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	407931	NY

General Provider Information

NPI Number	:	1265061741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHANIQUA CHARISSE HUNTER RN

Provider Business Mailing Address
First Line	:	7 LAWRENCE DR APT D
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-1348
Country	:	US
Telephone Number	:	918-655-3949
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 LAWRENCE DR APT D
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-1348
Country	:	US
Telephone Number	:	917-655-3949
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	01/09/2026

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