Provider Demographics
NPI:1184355984
Name:HILL, SHA'KERRIA KEIOSHA
Entity type:Individual
Prefix:
First Name:SHA'KERRIA
Middle Name:KEIOSHA
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 FAIRBANKS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-2319
Mailing Address - Country:US
Mailing Address - Phone:318-547-6527
Mailing Address - Fax:
Practice Address - Street 1:201 EE WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:FERRIDAY
Practice Address - State:LA
Practice Address - Zip Code:71334-2815
Practice Address - Country:US
Practice Address - Phone:225-223-2235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherCASE MANAGER/ CARE COORDINATOR