Provider Demographics
NPI:1073947131
Name:NASH, SHEKEENA LORRAINE
Entity Type:Individual
Prefix:MISS
First Name:SHEKEENA
Middle Name:LORRAINE
Last Name:NASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 DUNLAP RD
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-4302
Mailing Address - Country:US
Mailing Address - Phone:706-247-2953
Mailing Address - Fax:
Practice Address - Street 1:1135 CARTER ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2811
Practice Address - Country:US
Practice Address - Phone:803-786-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program