Provider Demographics
NPI:1487321576
Name:DOWDLE, SHAQUINDA ADDREINA (DNP, APRN, CNM)
Entity type:Individual
Prefix:DR
First Name:SHAQUINDA
Middle Name:ADDREINA
Last Name:DOWDLE
Suffix:
Gender:F
Credentials:DNP, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MYER LN
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-4886
Mailing Address - Country:US
Mailing Address - Phone:843-442-5038
Mailing Address - Fax:
Practice Address - Street 1:50 E HOSPITAL ST STE 4A
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:SC
Practice Address - Zip Code:29102-3149
Practice Address - Country:US
Practice Address - Phone:803-433-0797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCNM05360367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife