Individual
NICHOLLE RACHELLE SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3312 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1829
(702) 410-7825
Mailing address
3312 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1829
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
12345
NV
Other
Enumeration date
09/30/2020
Last updated
10/13/2020
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