Individual
SHAMEKA NICOLE MASON BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1395 EISENHOWER DR, SAVANNAH, GA 31406-3901
(912) 356-2157
Mailing address
2238 IOWA ST, SAVANNAH, GA 31404-1930
(912) 713-8178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN221070
GA
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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