Individual
TAMMIE LYNETTE SHELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2686 WICK ST SE, WARREN, OH 44484-5447
(614) 620-0197
Mailing address
2696 WICK ST SE, WARREN, OH 44484-5447
(614) 620-0197
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401558070813
OH
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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