Provider Demographics
NPI:1063791077
Name:NWAFOR, SHAMEKIA ANN (OD)
Entity type:Individual
Prefix:DR
First Name:SHAMEKIA
Middle Name:ANN
Last Name:NWAFOR
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 CLINE DR
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-7625
Mailing Address - Country:US
Mailing Address - Phone:337-781-5771
Mailing Address - Fax:
Practice Address - Street 1:3810 NE EVANGELINE TRWY
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-5966
Practice Address - Country:US
Practice Address - Phone:337-520-3009
Practice Address - Fax:337-896-9698
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1620-653T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist