Individual
SHAVANNA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1139 CLEMSON ST, CLAYMONT, DE 19703-3337
(610) 762-4413
Mailing address
1139 CLEMSON ST, CLAYMONT, DE 19703-3337
(610) 762-4413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN582169
PA
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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