Provider Demographics
NPI:1689334252
Name:DIVERSITY NURSING ACADEMY
Entity Type:Organization
Organization Name:DIVERSITY NURSING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKLEY SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:843-707-6630
Mailing Address - Street 1:53 YORK CT
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-6651
Mailing Address - Country:US
Mailing Address - Phone:843-707-6630
Mailing Address - Fax:
Practice Address - Street 1:53 YORK CT
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-6651
Practice Address - Country:US
Practice Address - Phone:843-707-6630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942873732OtherNPPES