Individual
SHMEIKA WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3608 STONE RD SW, ATLANTA, GA 30331-5306
(678) 768-0621
Mailing address
3608 STONE RD SW, ATLANTA, GA 30331-5306
(678) 768-0621
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
621209090009
GA
374U00000X
Home Health Aide
Primary
CN0000104698
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83-4540359
—
GA
Enumeration date
10/13/2020
Last updated
10/13/2020
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