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NPI Code Detail

MEDICARE: COMEAKA SHANNON KING

MEDICARE: COMEAKA SHANNON KING
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1669226718
Entity Type Code : Individual
Provider Name (Legal Business Name) : COMEAKA SHANNON KING
Provider Business Mailing Address
First Line : 6009 FINANCIAL PLZ STE 102
Second Line :
City : SHREVEPORT
State : LA
Zip : 71129-2615
Country : US
Telephone Number : 318-828-1455
Fax Number :
Provider Business Practice Location Address
First Line : 6009 FINANCIAL PLZ STE 102
Second Line :
City : SHREVEPORT
State : LA
Zip : 71129-2615
Country : US
Telephone Number : 318-828-1455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2024
Last Update Date : 05/20/2026

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Directions to “ COMEAKA SHANNON KING ” Practice Location

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