Individual
SHAKARRA CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4109 US HIGHWAY 51, MOUNDS, IL 62964-2208
(573) 270-7563
Mailing address
4109 US HIGHWAY 51, MOUNDS, IL 62964-2208
(573) 270-7563
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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