Individual
MRS. SHANDIS DENISE PHANEUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6545 GREGG DR, COLUMBUS, GA 31909
(334) 663-4278
Mailing address
6545 GREGG DR, COLUMBUS, GA 31909-3273
(334) 663-4278
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LON066099
GA
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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