Provider Demographics
NPI:1194342220
Name:STRICKLIN, NIESHA
Entity type:Individual
Prefix:
First Name:NIESHA
Middle Name:
Last Name:STRICKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 N MARKET ST APT 311
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71107-2902
Mailing Address - Country:US
Mailing Address - Phone:469-243-4826
Mailing Address - Fax:
Practice Address - Street 1:4302 N MARKET ST APT 311
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71107-2902
Practice Address - Country:US
Practice Address - Phone:469-243-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker