Provider Demographics
NPI:1699499764
Name:EAST, SHAKIRA NICOLE
Entity type:Individual
Prefix:
First Name:SHAKIRA
Middle Name:NICOLE
Last Name:EAST
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 1:756 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2357
Mailing Address - Country:US
Mailing Address - Phone:850-449-3026
Mailing Address - Fax:
Practice Address - Street 1:756 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2357
Practice Address - Country:US
Practice Address - Phone:850-449-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide