Provider Demographics
NPI:1891383857
Name:ODDMAN, SHAKIMA
Entity Type:Individual
Prefix:
First Name:SHAKIMA
Middle Name:
Last Name:ODDMAN
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 1:450 KENT AVE APT 7J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-5911
Mailing Address - Country:US
Mailing Address - Phone:347-979-4703
Mailing Address - Fax:
Practice Address - Street 1:450 KENT AVE APT 7J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-5911
Practice Address - Country:US
Practice Address - Phone:347-979-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula