Individual
SHIRELL DENISE LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2154 PIKE LAKE DR APT 3, NEW BRIGHTON, MN 55112-2483
(612) 875-8596
Mailing address
2154 PIKE LAKE DR APT 3, NEW BRIGHTON, MN 55112-2483
(612) 875-8596
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
92185420210311
MN
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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