Individual
TONIA SHEALEY-MARINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
120 ROSE WAY, STOCKBRIDGE, GA 30281-3162
(313) 779-2857
Mailing address
120 ROSE WAY, STOCKBRIDGE, GA 30281-3162
(313) 779-2857
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LPN087067
GA
164X00000X
Licensed Vocational Nurse
Primary
217206
TX
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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