Individual
TAHCARA SHORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3427 MELROSE RD, FAYETTEVILLE, NC 28304-1608
(910) 864-8739
(910) 864-8222
Mailing address
521 NORTHWOODS DR, RAEFORD, NC 28376-5864
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
83246
NC
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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