Provider Demographics
NPI:1568897411
Name:ASHFORD, SHAMEKKA M (RN)
Entity Type:Individual
Prefix:
First Name:SHAMEKKA
Middle Name:M
Last Name:ASHFORD
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 1:3623 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2821
Mailing Address - Country:US
Mailing Address - Phone:414-610-4623
Mailing Address - Fax:
Practice Address - Street 1:3623 N 57TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2821
Practice Address - Country:US
Practice Address - Phone:414-610-4623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI197334163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse