Individual
SHAMEKIA SHUNTELL RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3809 ROSEWOOD DR, COLUMBIA, SC 29205-3533
(803) 939-2642
(803) 754-7783
Mailing address
323 KELLWOOD WAY, COLUMBIA, SC 29229-7578
(803) 422-9955
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
45082
SC
Other
Enumeration date
09/19/2019
Last updated
09/19/2019
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