Individual
SHAMICHAEL FLAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1520 IVY MEADOW DR APT 924, CHARLOTTE, NC 28213-9035
(315) 876-4664
Mailing address
1520 IVY MEADOW DR APT 924, CHARLOTTE, NC 28213-9035
(315) 876-4664
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
091380
NC
164W00000X
Licensed Practical Nurse
330094
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091380
NURSING LICENSE
NC
Enumeration date
11/11/2021
Last updated
11/11/2021
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