Provider Demographics
NPI:1134870967
Name:GUERRERO, SHAMEKA NICOLE (LPN)
Entity type:Individual
Prefix:MS
First Name:SHAMEKA
Middle Name:NICOLE
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHAMEKA
Other - Middle Name:NICOLE
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5600 SPRING PARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5988
Mailing Address - Country:US
Mailing Address - Phone:904-737-5000
Mailing Address - Fax:
Practice Address - Street 1:5600 SPRING PARK RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-5988
Practice Address - Country:US
Practice Address - Phone:904-737-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5224190164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse