Individual
MISS SHANTELLE ELIZABETH COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3333 36TH ST SE, KENTWOOD, MI 49512-2809
(616) 726-1966
Mailing address
8325 84TH ST SE, CALEDONIA, MI 49316-8042
(616) 366-7739
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704277805
MI
Other
Enumeration date
01/21/2014
Last updated
03/16/2022
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