Shanique A Devonish

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

041643 Issued in CT

Practice address

153 Hazard Ave
Enfield, CT 06082-4592

Phone

(860) 731-5522

Fax

(860) 731-5536

NPI assigned

Mar 10, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1942901574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVONISH",
        "first_name": "SHANIQUE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "041643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Desantis, MD
• Michelle Desjardins
• Destined to Thrive, LLC
• Robin F Deutsch, M.D.
• Samuel P Deveau
• Rishi Dhamija
• Mirza Diaz-Gonzalez
• Frank Dichiaro
• Mela Dieujuste, LCSW
• Tammy Dillard

• Licensed Practical Nurse in Enfield, CT
• Providers in Enfield, CT by specialty
• Licensed Practical Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.