Provider Demographics
NPI:1447938147
Name:SHAKESPEARE, MAKAILA CRISTINE (LM, CPM)
Entity type:Individual
Prefix:
First Name:MAKAILA
Middle Name:CRISTINE
Last Name:SHAKESPEARE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 COACHLIGHT LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3347
Mailing Address - Country:US
Mailing Address - Phone:832-248-8253
Mailing Address - Fax:281-456-3054
Practice Address - Street 1:8845 SIX PINES DR STE 150
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-4296
Practice Address - Country:US
Practice Address - Phone:713-907-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99506176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife