Individual
SHALUNDA D WIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
620 FALCONS RDG, MCDONOUGH, GA 30253-7753
(678) 237-6231
Mailing address
620 FALCONS RDG, MCDONOUGH, GA 30253-7753
(678) 237-6231
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN235338
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003216631A
—
GA
Enumeration date
03/11/2021
Last updated
03/11/2021
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