Individual
SHAWNA LOUISE PORUMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
21258 NORTH 81ST AVE., PEORIA, AZ 85382-4414
(623) 412-4907
Mailing address
8040 W YUKON DR, PEORIA, AZ 85382-5425
(602) 334-3204
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN106439
AZ
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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