Individual
MRS. SHANTELLA EVETTE THOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2485 HEMBY LN, GREENVILLE, NC 27834-3701
(888) 549-1922
Mailing address
6361 DAY LILLY LN, CHARLOTTE, NC 28216-8839
(704) 771-0522
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100037
NC
Other
Enumeration date
01/27/2014
Last updated
12/17/2015
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