Provider Demographics
NPI:1083057889
Name:LANE, SHENEKA YVONNE (CNA)
Entity Type:Individual
Prefix:
First Name:SHENEKA
Middle Name:YVONNE
Last Name:LANE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:SHENEKA
Other - Middle Name:YVONNE
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:2208 AFTON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-8104
Mailing Address - Country:US
Mailing Address - Phone:804-496-9828
Mailing Address - Fax:
Practice Address - Street 1:2208 AFTON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-8104
Practice Address - Country:US
Practice Address - Phone:804-496-9828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1401150248376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide