Individual
SHAWNA DEPACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
91 FIDDLERS LN, LATHAM, NY 12110-5343
(518) 285-1869
Mailing address
91 FIDDLERS LN, LATHAM, NY 12110-5343
(518) 285-1869
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
704218
NY
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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