Individual
SHANELL H VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
198 CHARLTON RD, STURBRIDGE, MA 01566
(508) 347-9240
(508) 347-5361
Mailing address
PO BOX 40, SOUTHBRIDGE, MA 01550-0040
(508) 909-7799
(508) 764-2432
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2289391
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2289391
MA
Other
Enumeration date
03/06/2014
Last updated
01/15/2019
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