Provider Demographics
NPI:1255168332
Name:MORGAN, SHENIKQUA
Entity type:Individual
Prefix:
First Name:SHENIKQUA
Middle Name:
Last Name:MORGAN
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 1:108 S HAINES ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-1543
Mailing Address - Country:US
Mailing Address - Phone:252-325-1567
Mailing Address - Fax:252-316-1129
Practice Address - Street 1:108 S HAINES ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-1543
Practice Address - Country:US
Practice Address - Phone:252-325-1567
Practice Address - Fax:252-316-1129
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities