Provider Demographics
NPI:1700631710
Name:SWANIGAN, SHAMIKA LANISE
Entity type:Individual
Prefix:
First Name:SHAMIKA
Middle Name:LANISE
Last Name:SWANIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 ASHTON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3836
Mailing Address - Country:US
Mailing Address - Phone:586-604-5847
Mailing Address - Fax:
Practice Address - Street 1:6240 ASHTON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3836
Practice Address - Country:US
Practice Address - Phone:586-604-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide