Shakarra Childress
Individual provider Active NPI Nurse's Aide · Mounds, IL
NPI 1841726767 · NPPES record last updated May 11, 2017
Key facts
- NPI
- 1841726767
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- Practice address
- 4109 US Highway 51
Mounds, IL 62964-2208 - Phone
- (573) 270-7563
- NPI assigned
- May 11, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | Yes |
Addresses
Primary practice location
4109 US Highway 51
Mounds, IL 62964-2208
Mailing address
4109 US Highway 51
Mounds, IL 62964-2208
Phone (573) 270-7563
Other providers in Mounds, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.