Individual
MRS. CONNIE RAE SHREVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
8078 4TH ST, LAUREL HILL, FL 32567-2119
(850) 652-4111
(850) 652-4659
Mailing address
221 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5066
(850) 833-9240
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN1830422
FL
Other
Enumeration date
10/22/2007
Last updated
02/11/2008
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