Individual
SHANEIKA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3543 HIGHWAY 81, LOGANVILLE, GA 30052-4336
(678) 737-4147
Mailing address
4514 TRELLIS VIEW LN, LOGANVILLE, GA 30052-5919
(734) 657-7443
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN101480
GA
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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