Provider Demographics
NPI:1265061741
Name:HUNTER, SHANIQUA CHARISSE (RN)
Entity type:Individual
Prefix:MISS
First Name:SHANIQUA
Middle Name:CHARISSE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LAWRENCE DR APT D
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-1348
Mailing Address - Country:US
Mailing Address - Phone:918-655-3949
Mailing Address - Fax:
Practice Address - Street 1:7 LAWRENCE DR APT D
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1348
Practice Address - Country:US
Practice Address - Phone:917-655-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY603437163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & AdolescentGroup - Single Specialty