Provider Demographics
NPI:1326759069
Name:DANIELS, SHATIKA
Entity Type:Individual
Prefix:MRS
First Name:SHATIKA
Middle Name:
Last Name:DANIELS
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 1:2 VILLA VISTA LOOP
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-6708
Mailing Address - Country:US
Mailing Address - Phone:501-902-8847
Mailing Address - Fax:
Practice Address - Street 1:2 VILLA VISTA LOOP
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-6708
Practice Address - Country:US
Practice Address - Phone:501-902-8847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide