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NPI Code Detail

MEDICARE: SHAQUILL NELSON

MEDICARE: SHAQUILL NELSON
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
1246RP1900XPhlebotomy TechnicianF6D3R5Q3NC

General Provider Information

NPI Number : 1548103104
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAQUILL NELSON
Provider Business Mailing Address
First Line : 4726 DAWNWOOD DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-4711
Country : US
Telephone Number : 980-224-3640
Fax Number :
Provider Business Practice Location Address
First Line : 5960 FAIRVIEW RD STE 400
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3119
Country : US
Telephone Number : 980-224-3640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ SHAQUILL NELSON ” Practice Location

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