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NPI Code Detail

MEDICARE: SHAKIMA O MCNICHOL RN-BSN

MEDICARE: SHAKIMA O MCNICHOL RN-BSN
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
1164W00000XLicensed Practical Nurse314428-1NY
2174400000XSpecialist

General Provider Information

NPI Number : 1972925410
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAKIMA O MCNICHOL RN-BSN
Provider Business Mailing Address
First Line : 1133 WESTCHESTER AVE STE N-230
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10604-3522
Country : US
Telephone Number : 347-813-7677
Fax Number :
Provider Business Practice Location Address
First Line : 1133 WESTCHESTER AVE STE N-230
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10604-3522
Country : US
Telephone Number : 347-813-7677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2014
Last Update Date : 09/12/2022

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Directions to “ SHAKIMA O MCNICHOL RN-BSN” Practice Location

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