Individual
MICHELLE L SHANKS
Active
Individual
MICHELLE L SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
71639
HI
363LA2200X
Adult Health Nurse Practitioner
Primary
1452
HI
363LA2200X
Adult Health Nurse Practitioner
6147
KY
Other
Enumeration date
08/26/2009
Last updated
12/12/2019
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