SHANNON ALYSE NIKULA (NPI# 1508323510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508323510 |
| Entity Type | Individual |
| Full Name | SHANNON ALYSE NIKULA |
| Credential | SLP-A |
| Practice Address |
21168 E Tierra Grande Dr Queen Creek AZ 85142-6767 |
| Practice Telephone | 7028173160 |
| Mailing Telephone | 7028173160 |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
SLPA11256 | AZ | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA DRIVER'S LICENSE | D10928623 | 01 |
| Street Address |
21168 E TIERRA GRANDE DR |
| City | QUEEN CREEK |
| State | AZ |
| Zip Code | 85142-6767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093346033 | Arizona Dental Professionals, P.C. | Dentist | 20311 S Ellsworth Rd Ste 101, Queen Creek, AZ 85142 | 2020-01-29 |
| 1073158903 | Jonathan Corey Barber | Physical Therapy Assistant | 22424 South Ellsworth Loop Road, #464, Queen Creek, AZ 85142 | 2019-11-14 |
| 1689142333 | Erin Sohr | Occupational Therapy Assistant | 4594 W Federal Way, San Tan Valley, AZ 85142 | 2018-11-10 |
| 1083180723 | Katelyn Hannabach | Physician Assistant | 21323 S Ellsworth Loop Rd Ste 101, Queen Creek, AZ 85142 | 2018-10-20 |
| 1043701899 | Brittany Leigh Amor | Dentist | 18550 E Rittenhouse Rd Ste 103, Queen Creek, AZ 85142 | 2018-05-28 |
| 1861925604 | Shani Thompson | Student in an Organized Health Care Education/Training Program | 22437 S 209th Way, Queen Creek, AZ 85142 | 2017-04-08 |
| 1689115164 | 360 Physical Therapy LLC | Physical Therapist | 21576 S Ellsworth Loop Rd, 150, Queen Creek, AZ 85142 | 2017-03-16 |
| 1891233714 | Candee J. Eisenhart | Nurse Practitioner | 21321 E Ocotillo Rd Ste 102, Queen Creek, AZ 85142 | 2017-02-11 |
| 1790231546 | Carrie Church | Nurse Practitioner | 20185 E Ocotillo Rd Ste 104, Queen Creek, AZ 85142 | 2016-08-31 |
| 1669836649 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 22713 S. Ellsworth Road, Building A, Queen Creek, AZ 85142 | 2016-04-06 |
| Find all providers in zip 85142 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134632193 | Stacey Bonenberger | Specialist/Technologist | 22444 S 209th Way, Queen Creek, AZ 85142-4877 | 2017-11-13 |
| 1518401157 | Andrea Rowan | Specialist/Technologist | 20898 E Saddle Way, Queen Creek, AZ 85142-6552 | 2016-12-16 |
| 1124488960 | Aimee Bustos | Specialist/Technologist | 1302 W Plane Tree Ave, Queen Creek, AZ 85140-7679 | 2016-03-06 |
| 1154705150 | Amanda Stevens | Specialist/Technologist | 40300 N Simonton Blvd, Queen Creek, AZ 85140-3164 | 2015-07-20 |
| 1619386638 | Jessica Webb | Specialist/Technologist | 19670 E Reins Rd, Queen Creek, AZ 85142-8681 | 2014-08-04 |
| 1841613494 | Mary A Bak | Specialist/Technologist | 40388 N Parisi Pl, Queen Creek, AZ 85140-6826 | 2014-01-31 |
| 1003249533 | Michelle Marie Klym | Specialist/Technologist | 20061 E Rittenhouse Rd, Queen Creek, AZ 85142-9712 | 2013-08-20 |
| 1063792661 | Tracy B Wright | Specialist/Technologist | 21288 E Twin Acres Dr, Queen Creek, AZ 85142-6546 | 2011-08-26 |
| 1679852081 | Kylee Rai Nickerson | Specialist/Technologist | 21408 East Creosote Lane, Queen Creek, AZ 85142 | 2011-08-16 |
| 1669605531 | Jennifer Lynn Christensen | Specialist/Technologist | 21624 E Via Del Rancho, Queen Creek, AZ 85142-5362 | 2009-08-26 |
| Find all providers in QUEEN CREEK | ||||
| City | QUEEN CREEK |
| Zip Code | 85142 |
Please comment or provide details below to improve the information on SHANNON ALYSE NIKULA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.