Provider Demographics
NPI:1821874132
Name:SCOTT, SHANIKA (APRN)
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9127 SW 41ST ST APT 108
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7315
Mailing Address - Country:US
Mailing Address - Phone:305-409-5888
Mailing Address - Fax:
Practice Address - Street 1:9127 SW 41ST ST APT 108
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7315
Practice Address - Country:US
Practice Address - Phone:305-409-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028390363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily