Individual
MRS. SHAWNA MARIE POULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FA
Contact information
Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(812) 948-7417
Mailing address
PO BOX 890631, CHARLOTTE, NC 28289-0631
(812) 949-5582
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
28168418A
IN
Other
Enumeration date
08/26/2014
Last updated
08/17/2016
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