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1013797000
SHIVAUGHN WHITE
VALLEY STREAM, NY
NPI
1013797000
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 337825-01)
Enumeration Date
2023-10-05
Last Update Date
2023-10-05
Business Address
SHIVAUGHN WHITE
497 ROCKAWAY AVE
VALLEY STREAM, NY 11581-1909
Phone number: 718-845-2621
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Mailing Address
SHIVAUGHN WHITE
5609 BEVERLEY RD # 2
BROOKLYN, NY 11203-5407
Phone number: 631-552-1192
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