Individual
SHANICE BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
358 LONG AVE, HILLSIDE, NJ 07205-2041
(908) 994-9383
Mailing address
358 LONG AVE, HILLSIDE, NJ 07205-2041
(908) 994-9383
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07932800
NJ
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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