Provider Demographics
NPI:1013675933
Name:CAIN, SHEENA MAIREAD (LPN)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:MAIREAD
Last Name:CAIN
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 1:762 MAJESTIC DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-2254
Mailing Address - Country:US
Mailing Address - Phone:267-625-8306
Mailing Address - Fax:
Practice Address - Street 1:4553 WATKINS ST
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-2511
Practice Address - Country:US
Practice Address - Phone:850-905-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5250089164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse