Individual
MS. SUE ELLEN SHIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11902 SAINT PAUL RD, CLEAR SPRING, MD 21722-1946
(301) 842-2548
Mailing address
11902 SAINT PAUL RD, CLEAR SPRING, MD 21722-1946
(301) 842-2548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R173386
MD
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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