Individual
MS. SHANTELL LASHAWN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
325 YMCA RD, LEXINGTON, SC 29073-7602
(803) 445-3659
Mailing address
325 YMCA RD, LEXINGTON, SC 29073-7602
(803) 445-3659
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
125852E
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EX6726
—
SC
Enumeration date
06/05/2013
Last updated
06/05/2013
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