Individual
SHAQUELA D PEAVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 EMBRUN CT, KISSIMMEE, FL 34759-3460
(330) 550-0641
Mailing address
1003 EMBRUN CT, KISSIMMEE, FL 34759-3460
(330) 550-0641
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
401212700311
OH
376K00000X
Nurse's Aide
Primary
—
FL
Other
Enumeration date
09/04/2012
Last updated
03/16/2021
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