Individual
LATRICE JANIVA SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 EASTGATE DR, AIKEN, SC 29803-7688
(803) 643-3694
Mailing address
404 FIOLI CIR, GRANITEVILLE, SC 29829-3916
(803) 243-1088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
GAA-NP001142
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
F10220365
SC
Other
Enumeration date
10/06/2022
Last updated
02/08/2025
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