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Individual

MRS. SHANIQUA ROGERS DURRETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
313 N LA BREA AVE, INGLEWOOD, CA 90302-3400
(310) 912-0252
Mailing address
1526 W 47TH ST, LOS ANGELES, CA 90062-2047
(310) 912-0252

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95053562
CA
163WH0200X
Home Health Registered Nurse
95053562
CA
163WI0500X
Infusion Therapy Registered Nurse
Primary
95053562
CA
163WW0000X
Wound Care Registered Nurse
95053562
CA

Other

Enumeration date
10/18/2023
Last updated
10/18/2023
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