Provider Demographics
NPI:1265022248
Name:HAYGOOD, SHAMEKA (CNA)
Entity type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:
Last Name:HAYGOOD
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-3918
Mailing Address - Country:US
Mailing Address - Phone:662-402-0418
Mailing Address - Fax:
Practice Address - Street 1:816 JACKSON ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-3918
Practice Address - Country:US
Practice Address - Phone:662-402-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA075671376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide