Provider Demographics
NPI:1912677279
Name:ARCHER, SHANIQUEA NAYOUKA A (APRN)
Entity type:Individual
Prefix:
First Name:SHANIQUEA
Middle Name:NAYOUKA A
Last Name:ARCHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-0081
Mailing Address - Country:US
Mailing Address - Phone:561-660-5749
Mailing Address - Fax:561-660-5719
Practice Address - Street 1:7070 SEMINOLE PRATT WHITNEY RD STE 5
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3491
Practice Address - Country:US
Practice Address - Phone:561-660-5749
Practice Address - Fax:561-660-5719
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11015429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11015429OtherFLORIDA BOARD OF NURSING