Provider Demographics
NPI:1942910500
Name:TAYLOR, SHAMIKA MONIQUE (LPN)
Entity Type:Individual
Prefix:
First Name:SHAMIKA
Middle Name:MONIQUE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43608-1112
Mailing Address - Country:US
Mailing Address - Phone:614-230-9887
Mailing Address - Fax:
Practice Address - Street 1:31 E OAKLAND ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43608-1112
Practice Address - Country:US
Practice Address - Phone:614-230-9887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164-147164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse