Individual
ALICE SHELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
725 E MARKET ST, AKRON, OH 44305-2421
(330) 315-2704
Mailing address
725 E MARKET ST, AKRON, OH 44305-2421
(330) 315-2704
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 154940-M-IV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN 154940-M-IV
LPN
OH
Enumeration date
02/29/2016
Last updated
02/29/2016
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