Individual
JOQUANA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NA II
Contact information
Practice address
221 N ELM ST, LUMBERTON, NC 28358-5647
(910) 674-9271
Mailing address
PO BOX 7503, LUMBERTON, NC 28359-3095
(910) 674-9271
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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