Shaquana Latifah Nevels, LPN

Individual provider Active NPI Licensed Practical Nurse · Brighton, NY

NPI 1164069613 · NPPES record last updated Dec 3, 2019

Key facts

NPI
1164069613
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
337025-01 (NY)
Practice address
50 Knollbrook Rd Apt 3
Brighton, NY 14610-2158
Phone
(585) 287-2936
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
337025-01NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 337025-01 NY Yes

Addresses

Primary practice location

50 Knollbrook Rd Apt 3
Brighton, NY 14610-2158

Mailing address

50 Knollbrook Rd Apt 3
Brighton, NY 14610-2158
Phone (585) 287-2936

Other providers in Brighton, NY

All providers in Brighton, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.