Individual
CHERYL SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1137 SE PROCTOR LN, PORT ST LUCIE, FL 34983-3223
(772) 344-6926
Mailing address
1137 SE PROCTOR LN, PORT ST LUCIE, FL 34983-3223
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5148768
FL
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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