Provider Demographics
NPI:1477050565
Name:MCDOWELL, SHAKERAH VERNICE
Entity Type:Individual
Prefix:
First Name:SHAKERAH
Middle Name:VERNICE
Last Name:MCDOWELL
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 1:2006 CUSHMAN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-1635
Mailing Address - Country:US
Mailing Address - Phone:214-736-6299
Mailing Address - Fax:
Practice Address - Street 1:2006 CUSHMAN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1635
Practice Address - Country:US
Practice Address - Phone:214-736-6299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide