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Individual

JEANELLE SHALOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
119 LAZY LN APT A, SEALY, TX 77474-3535
(281) 845-1387
Mailing address
11929 UNIVERSITY BLVD STE 2M, SUGAR LAND, TX 77479-4757
(281) 238-8775

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
206207
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206207
TEXAS BOARD OF NURSING
TX
Enumeration date
07/29/2018
Last updated
07/29/2018
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