MEDICARE: MRS. SHANEKA STARKES

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	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1922883396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANEKA STARKES

Provider Business Mailing Address
First Line	:	2695 POST ST # 1056
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4230
Country	:	US
Telephone Number	:	800-383-5613
Fax Number	:

Provider Business Practice Location Address
First Line	:	2695 POST ST # 1056
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4230
Country	:	US
Telephone Number	:	800-383-5613
Fax Number	:

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

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/29/2023

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Directions to “ MRS. SHANEKA STARKES ” Practice Location

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