Most Relevant Information
Provider Data
| NPI Number: | 1003666199 |
| Provider Name: | SHAKIRA LEAKE PMHNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 28569 |
Most Important Dates
| Enumeration Date: | 03/25/2024 |
| Last Updated: | 05/30/2024 |
Provider Practice Location
250 DEWEY AVE
SPARTANBURG
SC
293033009
Practice Location Phone/Fax
| Phone: | 8645850366 |
| Fax: |
Provider Mailing Location
176 LONGVIEW RD
CROSS HILL
SC
293323124
Provider Mailing Phone/Fax
| Phone: | 8645474600 |
| Fax: |