Individual
SHATIVIUS C WEBSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1103 N 13TH ST APT A, FORT PIERCE, FL 34950-3218
(772) 243-1149
Mailing address
1717 ORANGE AVE UNIT 1523, FORT PIERCE, FL 34954-3365
(772) 243-1149
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
CNA399484
FL
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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