Individual
SHAMONDA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3212 INDIANA CT, FORT PIERCE, FL 34947-7244
(772) 466-4955
Mailing address
3212 INDIANA CT, FORT PIERCE, FL 34947-7244
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 5150688
FL
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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