LAQUANTA S SHAW NON TYPICAL NPI 1730735903

NPI Information

NPI: 1730735903
Provider Name: LAQUANTA S SHAW, NON TYPICAL
Classification: Driver - 172A00000X
Entity Type: Individual
Address:
4160 TAHOE CT
INDIANAPOLIS, IN
ZIP 46235
Phone: (317) 627-8590
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Laquanta S Shaw, NON TYPICAL is a driver in Indianapolis, IN. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. Laquanta S Shaw, NON TYPICAL NPI is 1730735903. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4160 TAHOE CT
INDIANAPOLIS, IN
ZIP 46235-823
Phone: (317) 627-8590

The enumeration date for this NPI number is 8/14/2019 and was last updated on 11/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	374U00000X	Home Health Aide		HHA0901819	INDIANA	No
2	172A00000X	Driver		2350-45-6933	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	152957	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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