Individual
CICELY SHANKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 UNIVERSITY AVE STE 2A, FAIRBANKS, AK 99709-3651
(907) 206-3000
(907) 331-0480
Mailing address
600 UNIVERSITY AVE STE 2A, FAIRBANKS, AK 99709-3651
(907) 206-3000
(907) 331-0480
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
146810
AK
Other
Enumeration date
05/22/2019
Last updated
07/26/2021
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