Provider Demographics
NPI:1730434085
Name:MCNICHOLS, SHENEKA ANNETTE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:SHENEKA
Middle Name:ANNETTE
Last Name:MCNICHOLS
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:600 VESTAVIA PKWY STE 251
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-7719
Mailing Address - Country:US
Mailing Address - Phone:205-419-7376
Mailing Address - Fax:844-325-0578
Practice Address - Street 1:600 VESTAVIA PKWY STE 251
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-7719
Practice Address - Country:US
Practice Address - Phone:205-419-7376
Practice Address - Fax:844-325-0578
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-100394363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics