Provider Demographics
NPI:1619486909
Name:DILLON, SHINEKIA VICTORIA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHINEKIA
Middle Name:VICTORIA
Last Name:DILLON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 AUTUMNDALE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36618-1342
Mailing Address - Country:US
Mailing Address - Phone:251-222-9751
Mailing Address - Fax:
Practice Address - Street 1:3854 AUTUMNDALE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36618-1342
Practice Address - Country:US
Practice Address - Phone:251-222-9751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-066822164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse