Misty Shadduck, LPN
NPI 1043080476ActiveIndividual· Licensed Practical Nurse· Mesa, AZ
Licensed Practical Nurse (LPN) in Mesa, Arizona, licensed in PA and NY, with an NPI issued in January 2024.
Overview
| NPI | 1043080476 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPN |
| Sole proprietor | No |
| NPI issued | Jan 5, 2024 |
| Last updated in NPPES | Jan 5, 2024 |
| Certified by provider | Jan 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | PN301121 | PA |
| Licensed Practical Nurse | 164W00000X | 32549101 | NY |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Licensed Practical Nurse providers in Mesa
- 1487078481
- 1629446398
- 1023926045
- 1659189777
- 1821544529
- 1639526064
- 1699547539
- 1417346883
- 1508149584
- 1568317980
- 1629444807
- 1124204003