Provider Demographics
NPI:1659510378
Name:ACHU, SHEKINAH PRAISEGOD (NURSE)
Entity Type:Individual
Prefix:
First Name:SHEKINAH
Middle Name:PRAISEGOD
Last Name:ACHU
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7547 RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6539
Mailing Address - Country:US
Mailing Address - Phone:817-808-2090
Mailing Address - Fax:
Practice Address - Street 1:7547 RIDGE LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-6539
Practice Address - Country:US
Practice Address - Phone:817-808-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2024-04-05
Deactivation Date:2023-11-21
Deactivation Code:
Reactivation Date:2023-12-18
Provider Licenses
StateLicense IDTaxonomies
376K00000X
TX305494164W00000X
DCLPN1004866164W00000X, 164W00000X
DC3069225100000X
OT43225X00000X
DC1003967372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No372600000XNursing Service Related ProvidersAdult Companion