Individual
SHANNON ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3006 RIBAULT SCENIC DR, JACKSONVILLE, FL 32208-2477
(904) 554-1696
Mailing address
3006 RIBAULT SCENIC DR, JACKSONVILLE, FL 32208-2477
(904) 554-1696
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
163236
FL
Other
Enumeration date
10/06/2020
Last updated
11/16/2023
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