Individual ProviderShanniqua MitchellRegistered NurseNursing Service ProvidersPractice Address230 N Main St, Spring Valley, NY 10977-4020(845) 363-8140PECOS EnrollmentBased on the most recent information from CMS, provider Shanniqua Mitchell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:54 AM.Profile DetailsProvider ID1528562105Provider TypeIndividualFull NameMitchell, ShanniquaGenderFemaleSole ProprietorYesEnumeration Date3/20/2018Last Updated6/16/2018Contact InformationPractice LocationPractice Address230 N Main St, Spring Valley, NY 10977-4020Phone(845) 363-8140FaxUnlisted FaxMailing LocationMailing Address230 N Main St, Spring Valley, NY 10977-4020PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense627210New YorkProvider IdentifiersIDDescriptionIssuerID627210DescriptionOtherIssuerLICENSENew York