Individual
SHIRLEY DELORISE BALTRIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA CERTIFICATE
Contact information
Practice address
5112 WAVING FLOWER DR, NORTH LAS VEGAS, NV 89031-6269
(702) 695-6191
Mailing address
116 CREEK WAY LN, COLUMBIA, SC 29209-5720
(803) 409-9444
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
0749881
SC
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/07/2009
Last updated
06/05/2019
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