Provider Demographics
NPI:1407501380
Name:MACKEY, SHAMEKA
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:
Last Name:MACKEY
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 1:8516 VISTA CHAMISA LN SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-7613
Mailing Address - Country:US
Mailing Address - Phone:505-401-6495
Mailing Address - Fax:
Practice Address - Street 1:8516 VISTA CHAMISA LN SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-7613
Practice Address - Country:US
Practice Address - Phone:505-401-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide