Provider Demographics
NPI:1528655883
Name:CLAGGETT, SHANEIL NICOLLA (RN)
Entity type:Individual
Prefix:
First Name:SHANEIL
Middle Name:NICOLLA
Last Name:CLAGGETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9406 SEA BREEZE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20714-3047
Mailing Address - Country:US
Mailing Address - Phone:410-474-5344
Mailing Address - Fax:
Practice Address - Street 1:9406 SEA BREEZE CT
Practice Address - Street 2:
Practice Address - City:NORTH BEACH
Practice Address - State:MD
Practice Address - Zip Code:20714-3047
Practice Address - Country:US
Practice Address - Phone:410-474-5344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2024-02-02
Deactivation Date:2020-12-28
Deactivation Code:
Reactivation Date:2024-02-02
Provider Licenses
StateLicense IDTaxonomies
MDRN220678163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse