Individual
SHANELL PEACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
905 TOWER RD # 3188, BRISTOL, PA 19007-3116
(443) 383-9300
(855) 866-8710
Mailing address
909 RIDGEBROOK RD STE 300, SPARKS, MD 21152-9477
(443) 383-9300
(855) 866-8710
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP025838
PA
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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