Provider Demographics
NPI:1922672070
Name:MAPP, SHAQUALA DENISE (MA)
Entity Type:Individual
Prefix:
First Name:SHAQUALA
Middle Name:DENISE
Last Name:MAPP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:SHAQUALA
Other - Middle Name:DENISE
Other - Last Name:MAPP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2010 HARDY ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37406-4517
Mailing Address - Country:US
Mailing Address - Phone:423-719-9811
Mailing Address - Fax:
Practice Address - Street 1:2010 HARDY ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37406-4517
Practice Address - Country:US
Practice Address - Phone:423-693-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-13
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN113113316374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide