Provider Demographics
NPI:1689401598
Name:ANIMASHAUN, SHERIFAT O
Entity type:Individual
Prefix:
First Name:SHERIFAT
Middle Name:O
Last Name:ANIMASHAUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 BOBTAIL CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-9808
Mailing Address - Country:US
Mailing Address - Phone:336-210-8014
Mailing Address - Fax:
Practice Address - Street 1:4008 BOBTAIL CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-9808
Practice Address - Country:US
Practice Address - Phone:336-210-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC7542163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health