Individual
MRS. ASHLEY ANNE SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3801 W MISSOURI AVE, PHOENIX, AZ 85019-2133
(602) 336-2646
(602) 242-2791
Mailing address
4510 N 37TH AVE, PHOENIX, AZ 85019-3206
(602) 336-2990
(602) 336-2271
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2011035509
MO
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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