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1528783065
LATRICE JANIVA SHELL
AIKEN, SC
NPI
1528783065
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: SC F10220365)
Enumeration Date
2022-10-06
Last Update Date
2022-10-06
Business Address
LATRICE JANIVA SHELL
550 EASTGATE DR
AIKEN, SC 29803-7688
Phone number: 803-643-3694
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Mailing Address
LATRICE JANIVA SHELL
404 FIOLI CIR
GRANITEVILLE, SC 29829-3916
Phone number: 803-243-1088
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