Provider Demographics
NPI:1558825760
Name:NIXON, SHAKEEMA LATOYIA (RN)
Entity Type:Individual
Prefix:
First Name:SHAKEEMA
Middle Name:LATOYIA
Last Name:NIXON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13333 WEST RD APT 334
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-6087
Mailing Address - Country:US
Mailing Address - Phone:203-945-9096
Mailing Address - Fax:
Practice Address - Street 1:13333 WEST RD APT 334
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-6087
Practice Address - Country:US
Practice Address - Phone:203-945-9096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072265163W00000X
NY319467164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Yes163W00000XNursing Service ProvidersRegistered Nurse