Individual
REBECCA SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5071
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
718246
TX
163WC1500X
Community Health Registered Nurse
Primary
718246
TX
163WL0100X
Lactation Consultant (Registered Nurse)
718246
TX
163WS0200X
School Registered Nurse
718246
TX
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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