Individual
SHANNE KAYANNE SHERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
673 SE STARFISH AVE, PORT ST LUCIE, FL 34983-4660
(772) 259-2190
Mailing address
673 SE STARFISH AVE, PORT ST LUCIE, FL 34983-4660
(772) 259-2190
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
239440
FL
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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