Provider Demographics
NPI:1508666066
Name:BRANCH, SHAKINA
Entity type:Individual
Prefix:
First Name:SHAKINA
Middle Name:
Last Name:BRANCH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 SAINT JAMES AVE # 143
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2768
Mailing Address - Country:US
Mailing Address - Phone:305-490-8290
Mailing Address - Fax:
Practice Address - Street 1:611 SPANISH WELLS RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7067
Practice Address - Country:US
Practice Address - Phone:305-490-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker