Provider Demographics
NPI:1265087886
Name:ZEMKE, SHEENA DANIELLE (RN)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:DANIELLE
Last Name:ZEMKE
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 1:2 ALBERT LN
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7604
Mailing Address - Country:US
Mailing Address - Phone:505-659-6604
Mailing Address - Fax:
Practice Address - Street 1:2 ALBERT LN
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7604
Practice Address - Country:US
Practice Address - Phone:505-659-6604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-70963163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool