Provider Demographics
NPI:1396432068
Name:COX, SHEMIKA L (LPN)
Entity type:Individual
Prefix:
First Name:SHEMIKA
Middle Name:L
Last Name:COX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:GA
Mailing Address - Zip Code:39846-4020
Mailing Address - Country:US
Mailing Address - Phone:229-366-1491
Mailing Address - Fax:
Practice Address - Street 1:973 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:GA
Practice Address - Zip Code:39846-4020
Practice Address - Country:US
Practice Address - Phone:229-366-1491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN095536164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse