Individual
MRS. INEZ IDA SHANKS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
REGISTER NURSE
Contact information
Practice address
1061 HARMON AVE, STE 1 D03, FORT STEWART, GA 31314-5604
(912) 435-6933
Mailing address
971 FOX HAVEN CT, HINESVILLE, GA 31313-4950
(912) 369-3383
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
163WC1500X
GA
Other
Enumeration date
11/07/2005
Last updated
07/08/2007
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