Provider Demographics
NPI:1487302451
Name:SIMPSON, SHAKENDA (CNA)
Entity type:Individual
Prefix:MISS
First Name:SHAKENDA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:MRS
Other - First Name:SHAKENDA
Other - Middle Name:
Other - Last Name:DORSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1607 BARRINGTON VW
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-1846
Mailing Address - Country:US
Mailing Address - Phone:678-582-9317
Mailing Address - Fax:
Practice Address - Street 1:1607 BARRINGTON VW
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-1846
Practice Address - Country:US
Practice Address - Phone:678-582-9317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty