Search › Florida › 374U00000X
Shenikwa Wallace-Jackson
NPI 1598287187 · on the registry since 2017
Practice
- Address
- 177 Daffodil Dr Sw # D102
Palm Bay, FL 32908 - Phone
- (321) 223-2659
Registry record
- Primary taxonomy
- 374U00000X
374U00000X
- Also registered as
- 376J00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida