Provider Demographics
NPI:1083307904
Name:CRITTON, SHAMEKA LAKAUN
Entity Type:Individual
Prefix:MS
First Name:SHAMEKA
Middle Name:LAKAUN
Last Name:CRITTON
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 1:302 MARBLE DR
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:LA
Mailing Address - Zip Code:71040-5005
Mailing Address - Country:US
Mailing Address - Phone:318-225-2958
Mailing Address - Fax:318-225-3138
Practice Address - Street 1:302 MARBLE DR
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:LA
Practice Address - Zip Code:71040-5005
Practice Address - Country:US
Practice Address - Phone:318-225-2958
Practice Address - Fax:318-225-3138
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health