Individual
MRS. SHELLEY NICOLE AVERETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
925 ETHEL AVE, DAYTON, OH 45417-3659
(937) 510-2215
Mailing address
925 ETHEL AVE, DAYTON, OH 45417-3659
(937) 510-2215
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN. 127395
OH
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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