Shaw, Laquanta S

Shaw, Laquanta S is an individual health care provider with primary practice located at 4160 Tahoe Ct , Indianapolis IN 46235-8823. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Home Health Aide, Other Service Providers / Driver. Other Service Providers / Driver is her primary health care specialty. Shaw, Laquanta S can be contacted via phone (317) 627-8590.

Contact Information

Primary practice address
4160 Tahoe Ct Indianapolis IN 46235-8823
Phone: (317) 627-8590
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Home Health Aide 374U00000X HHA0901819 Indiana
Other Service Providers / Driver 172A00000X 2350-45-6933 Indiana

Profile Details

NPI number 1730735903
LBN Legal business name Shaw, Laquanta S
Credentials NON TYPICAL
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2019
Last updated Nov 29th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730735903 NPPES
Indiana MEDICAID 152957

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