Provider Demographics
NPI:1861280430
Name:APPLEWHITE, SHANYQUE NATASHA
Entity type:Individual
Prefix:MS
First Name:SHANYQUE
Middle Name:NATASHA
Last Name:APPLEWHITE
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 1:3321 CANDELARIA RD NE STE 135
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1967
Mailing Address - Country:US
Mailing Address - Phone:505-930-8235
Mailing Address - Fax:
Practice Address - Street 1:3321 CANDELARIA RD NE STE 135
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1967
Practice Address - Country:US
Practice Address - Phone:505-930-8235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-11-25
Deactivation Date:2025-06-16
Deactivation Code:
Reactivation Date:2025-11-25
Provider Licenses
StateLicense IDTaxonomies
NM376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker