Individual
MRS. SHINITA FAVORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 314-7500
Mailing address
36065 SANTA FE AVENUE, FORT HOOD, TX 76544-4752
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024173637
VA
Other
Enumeration date
02/08/2016
Last updated
08/16/2024
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