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Individual

TANJI SHIVENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
611 FOREST AVE, MAYSVILLE, KY 41056-1411
(606) 564-4016
Mailing address
611 FOREST AVE, MAYSVILLE, KY 41056-1411
(606) 564-4016

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1144521
KY

Other

Enumeration date
09/26/2019
Last updated
09/26/2019
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