Provider Demographics
NPI:1952299364
Name:ALLEN, SHAKIRA T (LPN)
Entity type:Individual
Prefix:MS
First Name:SHAKIRA
Middle Name:T
Last Name:ALLEN
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 1:756 BELLPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-1625
Mailing Address - Country:US
Mailing Address - Phone:631-295-0117
Mailing Address - Fax:
Practice Address - Street 1:756 BELLPORT AVE
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-1625
Practice Address - Country:US
Practice Address - Phone:631-295-0117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349034-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse