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1538444989
SHANDA NICOLE FREDERICK
NEWARK, NJ
NPI
1538444989
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NJ 26NP06593200)
Enumeration Date
2011-10-17
Last Update Date
2011-10-17
Business Address
-- SHANDA NICOLE FREDERICK LPN
633 S 19TH ST 1ST FL
NEWARK, NJ 07103-1116
Phone number: 862-576-7768
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Mailing Address
-- SHANDA NICOLE FREDERICK LPN
633 S 19TH ST 1ST FL
NEWARK, NJ 07103-1116
Phone number: 862-576-7768
Copy
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