MISTY SHADDUCK

MESA, AZ
NPI1043080476
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: PA  PN301121)
Additional Taxonomies164W00000X Licensed Practical Nurse
(Licence: NY  32549101)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-01-05
Last Update Date2024-01-05
Business Address
MISTY SHADDUCK LPN
455 N MESA DR STE 8E
MESA, AZ 85201-5996
Phone number: 937-768-2544
Mailing Address
MISTY SHADDUCK LPN
70 S VAL VISTA DR # A3-618
GILBERT, AZ 85296-1374
Phone number: