Individual
SHYWHANN DENISE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2418NW 18TH ST., OCALA, FL 34475
(352) 207-2453
Mailing address
2418NW 18TH ST., OCALA, FL 34475
(352) 207-2453
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5171693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693660179
—
FL
Enumeration date
07/05/2012
Last updated
07/05/2012
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