SAMANTHA SHACKLEFORD (Credential# 1679282) is licensed (Advanced Practice Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is September 25, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.
SAMANTHA SHACKLEFORD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #12.008504. The credential type is advanced practice registered nurse. The effective date is September 25, 2019. The expiration date is September 30, 2020. The business address is 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067. The current status is active.
| Licensee Name | SAMANTHA SHACKLEFORD |
| Credential ID | 1679282 |
| Credential Number | 12.008504 |
| Credential Type | Advanced Practice Registered Nurse |
| Business Address |
1 Cityplace Dr Ste 570 Saint Louis MO 63141-7067 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-09-25 |
| Effective Date | 2019-09-25 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2019-09-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1669736 | 10.164177 | Registered Nurse | 2019-09-04 | 2019-09-04 - 2020-09-30 | ACTIVE |
| Street Address | 1 CITYPLACE DR STE 570 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7067 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tracy Lynne Reeder | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Vanessa Kitzis | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Dee Walker Ford | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Mary Ellen Mcdonough | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Steven Branham | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Brett Nathan Whaley | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Timothy Michael Stock | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jason Nguyen | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kara Diane Skrodzki | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Analiza Salvador Petero | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eboni C January | 910 Morrison Ave, St Louis, MO 63141 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Guy Elise Constant De Gent | One Cityplace Dr, Suite 570, Saint Louis, MO 63141 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| William P Mcmahon | 670 Mason Ridge Center Dr #220, St Louis, MO 63141 | Architect | 2020-08-01 ~ 2021-07-31 |
| Debra Kay Scudder | 12917 Gallagher Road, St. Louis, MO 63141 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Go Live Well | 13035 Olive Blvd Ste #210, Saint Louis, MO 63141 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Michael Cummins Cpa PC | Three The Pines Court Ste E, St. Louis, MO 63141 | Certified Public Accountant Firm Permit | 2020-01-01 ~ 2020-12-31 |
| Michael Cummins Cpa | 3 The Pines Ct Ste E, St. Louis, MO 63141 | Certified Public Accountant Certificate | 2020-01-01 ~ 2020-12-31 |
| Kali Marie Boland | 12750 Hezel Lane, Creve Coeur, MO 63141 | Physical Therapist | 2019-11-04 ~ 2020-10-31 |
| Romona Patrice Green | One Cityplace Drive, Saint Louis, MO 63141 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Isabelle Evelyn Condict | 711 Country Manor Lane, Creve Coeur, MO 63141 | Registered Nurse | 2018-05-01 ~ 2019-04-30 |
| Find all Licenses in zip 63141 | |||
| City | SAINT LOUIS |
| Zip Code | 63141 |
| License Type | Advanced Practice Registered Nurse |
| License Type + County | Advanced Practice Registered Nurse + SAINT LOUIS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samantha M Macphail | 25 Edgewood Dr, Wallingford, CT 06492-2132 | Advanced Practice Registered Nurse | 2019-11-07 ~ 2020-10-31 |
| Samantha T Belmont | 17 Scenic Hill Rd, Trumbull, CT 06611-2506 | Advanced Practice Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Samantha M Harris | 155 Windermere Ave Unit 2207, Ellington, CT 06029-5827 | Advanced Practice Registered Nurse | 2018-05-01 ~ 2019-04-30 |
| Kim E Cotnoir | Po Box 656, Johnson, VT 05656-0656 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Barbara J Voskowsky | Po Box 431, Granby, CT 06035-0431 | Advanced Practice Registered Nurse | 2011-08-01 ~ 2012-07-31 |
| Natanya Ma | 79 Daniels Rd, Rowley, MA 01969-2214 | Advanced Practice Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Erin R Swiggum | Po Box 129, La Farge, WI 54639-0129 | Advanced Practice Registered Nurse | 2015-12-01 ~ 2016-11-30 |
| Robert S Simkins | 466 N Salina St Apt 7, Syracuse, NY 13203-1837 | Advanced Practice Registered Nurse | ~ |
| Chieu Le | 113 Willow St, Chelsea, MA 02150-3306 | Advanced Practice Registered Nurse | 2016-10-27 ~ 2017-08-31 |
| Dianne E Carter | 26 Pal Dr, Shrewsbury, MA 01545 | Advanced Practice Registered Nurse | 2004-04-22 ~ 2005-05-31 |
Please comment or provide details below to improve the information on SAMANTHA SHACKLEFORD.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).