Provider Demographics
NPI:1821774977
Name:LEE, SHANITA CHERI
Entity Type:Individual
Prefix:MRS
First Name:SHANITA
Middle Name:CHERI
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8137 QUILL POINT DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4339
Mailing Address - Country:US
Mailing Address - Phone:202-336-4735
Mailing Address - Fax:
Practice Address - Street 1:8137 QUILL POINT DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4339
Practice Address - Country:US
Practice Address - Phone:202-336-4735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant