Provider Demographics
NPI:1194472845
Name:NEWKIRK, SHAHIDA (RN)
Entity Type:Individual
Prefix:
First Name:SHAHIDA
Middle Name:
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8104 MARIN POINTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4664
Mailing Address - Country:US
Mailing Address - Phone:347-218-3896
Mailing Address - Fax:
Practice Address - Street 1:8104 MARIN POINTE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4664
Practice Address - Country:US
Practice Address - Phone:347-218-3896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN98416163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse