Individual
SHIREE SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
3913 FRIAR ST, PIKESVILLE, MD 21208-2355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R170628
MD
Other
Enumeration date
06/05/2009
Last updated
06/05/2009
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