Provider Demographics
NPI:1285443556
Name:WOODSON, SHAQUETA (LPN)
Entity type:Individual
Prefix:
First Name:SHAQUETA
Middle Name:
Last Name:WOODSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 COLUMBIA ST STE 2-100
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2377
Mailing Address - Country:US
Mailing Address - Phone:518-719-8066
Mailing Address - Fax:
Practice Address - Street 1:886 COLUMBIA ST STE 2-100
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2377
Practice Address - Country:US
Practice Address - Phone:518-719-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348266164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse