Provider Demographics
NPI:1346457306
Name:SPARKMAN, SHAMIKA N
Entity Type:Individual
Prefix:MS
First Name:SHAMIKA
Middle Name:N
Last Name:SPARKMAN
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 1:305 FOREST OAK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-3778
Mailing Address - Country:US
Mailing Address - Phone:501-241-0253
Mailing Address - Fax:
Practice Address - Street 1:305 FOREST OAK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3778
Practice Address - Country:US
Practice Address - Phone:501-241-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist