Individual
SHAQUANDA DESHAWN MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-6428
(336) 716-2525
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018396
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
104712124
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
5018396
NC
Other
Enumeration date
07/10/2023
Last updated
10/04/2023
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