Individual
SHELBY WANAMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5736 MANCHESTER HWY, MORRISON, TN 37357-7503
(931) 815-3871
(931) 815-3876
Mailing address
110 GENTRY ST, MCMINNVILLE, TN 37110-1808
(931) 743-4341
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
90429
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90429
LICENSE
TN
Enumeration date
07/15/2020
Last updated
07/15/2020
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