Individual
ALICIA MARIE SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1511 W BROAD ST, COLUMBUS, OH 43222-1000
(614) 222-3525
(614) 222-3608
Mailing address
1511 W BROAD ST, COLUMBUS, OH 43222-1000
(614) 222-3525
(614) 222-3608
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN08809
OH
363LW0102X
Women's Health Nurse Practitioner
Primary
RN302973
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2625805
—
OH
Enumeration date
07/17/2006
Last updated
03/16/2017
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