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Individual
SHADELL DANAE MARIA WOMACK III
Active
Individual
SHADELL DANAE MARIA WOMACK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
717412
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
00000000
—
Enumeration date
04/20/2021
Last updated
12/12/2023
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