Individual
MR. SHIRREE SHINELLEC HOLLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.A
Contact information
Practice address
248 N FAIRGROUNDS ST, JACKSON, TN 38301-5130
(731) 225-4412
Mailing address
248 N FAIRGROUNDS ST, JACKSON, TN 38301-5130
(731) 225-4412
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
115963
TN
376K00000X
Nurse's Aide
A070530
MS
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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