Provider Demographics
NPI:1740162825
Name:ARKADIE, TEQUELLA SHAUNTA (CPT)
Entity type:Individual
Prefix:
First Name:TEQUELLA
Middle Name:SHAUNTA
Last Name:ARKADIE
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 MAPLE DR NE
Mailing Address - Street 2:STE 240 PMB2386
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2509
Mailing Address - Country:US
Mailing Address - Phone:720-288-0439
Mailing Address - Fax:
Practice Address - Street 1:280 NORTHERN AVE APT 35C
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1261
Practice Address - Country:US
Practice Address - Phone:720-288-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA25-CPT392246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy