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Individual

SHENITA MCCRIMAGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1655 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8105
(904) 403-1335
Mailing address
1655 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8105
(904) 403-1335

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
2662
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
854248764
FL
Enumeration date
04/13/2021
Last updated
04/13/2021
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