Provider Demographics
NPI:1477441061
Name:STEVENS, SHAELISHIA LATOYA
Entity type:Individual
Prefix:
First Name:SHAELISHIA
Middle Name:LATOYA
Last Name:STEVENS
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 1:5027 STIRRUP CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8483
Mailing Address - Country:US
Mailing Address - Phone:470-278-4297
Mailing Address - Fax:
Practice Address - Street 1:5027 STIRRUP CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8483
Practice Address - Country:US
Practice Address - Phone:470-278-4297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide