Provider Demographics
NPI:1326488933
Name:WILLIAMS, SHAQUITA MONQUIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHAQUITA
Middle Name:MONQUIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16TH STB
Mailing Address - Street 2:CMR 459 BOX 08408
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09139
Mailing Address - Country:US
Mailing Address - Phone:314-469-7852
Mailing Address - Fax:
Practice Address - Street 1:16TH STB
Practice Address - Street 2:CMR 459 BOX 08408
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09139
Practice Address - Country:US
Practice Address - Phone:314-469-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN063109164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse