Individual
SHONTA SHALONDA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6817 N 41ST ST, MILWAUKEE, WI 53209-2202
(414) 322-9190
Mailing address
6817 N 41ST ST, MILWAUKEE, WI 53209-2202
(414) 322-9190
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304283-031
WI
Other
Enumeration date
05/17/2009
Last updated
05/17/2009
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