Provider Demographics
NPI:1841906435
Name:FRANCIS, SHANIQUE RENEE TERRY-ANN (FNP)
Entity type:Individual
Prefix:
First Name:SHANIQUE
Middle Name:RENEE TERRY-ANN
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHANIQUE
Other - Middle Name:RENEE TERRY-ANN
Other - Last Name:CROOKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 932958, OH
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:774 GA HWY 96
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005
Practice Address - Country:US
Practice Address - Phone:478-988-5711
Practice Address - Fax:478-988-5712
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGAA-NP000999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily