Provider Demographics
NPI:1043828106
Name:BYRD, SHONKEISHA L (NP)
Entity type:Individual
Prefix:
First Name:SHONKEISHA
Middle Name:L
Last Name:BYRD
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:470-832-6550
Mailing Address - Fax:877-887-6103
Practice Address - Street 1:3571 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-4017
Practice Address - Country:US
Practice Address - Phone:470-832-6550
Practice Address - Fax:877-887-6103
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2023-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN176478363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology