Individual
SAMANTHA SHANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
224 N HIGHWAY 67 ST, SUITE 231, FLORISSANT, MO 63031-5904
(636) 344-9357
Mailing address
224 N HIGHWAY 67 ST, SUITE 231, FLORISSANT, MO 63031-5904
(636) 344-9357
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2007029968
MO
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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