Provider Demographics
NPI:1326839630
Name:WEST, SHACOLA ANNETTE
Entity type:Individual
Prefix:
First Name:SHACOLA
Middle Name:ANNETTE
Last Name:WEST
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 1:6010 SAINT MORITZ DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-6471
Mailing Address - Country:US
Mailing Address - Phone:202-553-0024
Mailing Address - Fax:
Practice Address - Street 1:6010 SAINT MORITZ DR
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-6471
Practice Address - Country:US
Practice Address - Phone:202-553-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant