Individual
SHANTA LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE AIDE
Contact information
Practice address
10016 OAK RUN DR APT H, CHARLOTTE, NC 28210-0139
(937) 361-1438
Mailing address
10016 OAK RUN DR APT H, CHARLOTTE, NC 28210-0139
(937) 361-1438
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
541922
NC
Other
Enumeration date
02/20/2021
Last updated
02/22/2021
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