Provider Demographics
NPI:1144742057
Name:RODGERS, SHAKEENA
Entity Type:Individual
Prefix:
First Name:SHAKEENA
Middle Name:
Last Name:RODGERS
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 1:27472 KING WILLIAM RD
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:VA
Mailing Address - Zip Code:23181
Mailing Address - Country:US
Mailing Address - Phone:804-316-1776
Mailing Address - Fax:
Practice Address - Street 1:27472 KING WILLIAM RD
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:VA
Practice Address - Zip Code:23181-3504
Practice Address - Country:US
Practice Address - Phone:804-316-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi