Individual
MRS. SHAUNIA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
126 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-8952
(573) 596-1766
Mailing address
24579 TRUE DR, SAINT ROBERT, MO 65584-3802
(573) 452-1644
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2005017614
MO
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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