Individual
MRS. TINA L SHELLEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
(626) 237-4810
Mailing address
7301 N 58TH AVE, GLENDALE, AZ 85301-1893
(626) 237-4810
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP046759
AZ
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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