Individual
KIMBERLY MARIE SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
431 MEADOWLARK RD, SHAW AFB, SC 29152
(803) 895-6592
Mailing address
431 MEADOWLARK RD, SHAW AFB, SC 29152
(803) 895-6592
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
676752
TX
Other
Enumeration date
02/10/2006
Last updated
11/23/2007
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