Provider Demographics
NPI:1881270569
Name:JAMES, SHATIKA ZENOBIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:SHATIKA
Middle Name:ZENOBIA
Last Name:JAMES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 OLD TARRYTOWN RD APT 608
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-5623
Mailing Address - Country:US
Mailing Address - Phone:646-234-8036
Mailing Address - Fax:
Practice Address - Street 1:355 OLD TARRYTOWN RD APT 608
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-5623
Practice Address - Country:US
Practice Address - Phone:646-234-8036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347447363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty