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1659495356
JOHNNY R SHUPE
DUFFIELD, VA
NPI
1659495356
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024151769)
Enumeration Date
2007-03-19
Last Update Date
2009-08-12
Business Address
-- JOHNNY R SHUPE APRN
373 CECIL D QUILLEN DR SUITE 101
DUFFIELD, VA 24244-4085
Phone number: 276-431-1638
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Mailing Address
-- JOHNNY R SHUPE APRN
3609 HEMLOCK PARK DR
KINGSPORT, TN 37663-2063
Phone number: 423-239-3431
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