Individual
SHANDELON GARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2240 WINROW RD, FORT HUACHUCA, AZ 85613-5080
(520) 533-5126
Mailing address
127 CARLSON LOOP, FORT HUACHUCA, AZ 85613
(318) 218-5688
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-117468
AL
163WC1500X
Community Health Registered Nurse
Primary
186149
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186149
RN LICENSE
AZ
Enumeration date
09/01/2016
Last updated
09/01/2016
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