Provider Demographics
NPI:1710679758
Name:SILLMON, NUKEYSHA LAFAY (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:NUKEYSHA
Middle Name:LAFAY
Last Name:SILLMON
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 DABNEY ST
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2925
Mailing Address - Country:US
Mailing Address - Phone:904-402-3706
Mailing Address - Fax:
Practice Address - Street 1:304 DABNEY ST
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2925
Practice Address - Country:US
Practice Address - Phone:904-402-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-147471163WP0200X, 163WP2201X, 163WN1003X, 163WW0000X, 251F00000X, 251J00000X, 253Z00000X, 332U00000X, 163WH0200X, 163WC1600X, 163WC2100X, 163WD0400X, 163WG0000X, 163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control