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1700315967
SHANNON JIM
TUBA CITY, AZ
NPI
1700315967
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376K00000X Nurse's Aide
(Licence: AZ CNA1000047755)
Enumeration Date
2017-06-09
Last Update Date
2017-06-09
Business Address
SHANNON JIM CNA
167 NORTH MAIN STREET
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2501
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Mailing Address
SHANNON JIM CNA
PO BOX 600 PFS BUSINESS OFFICE
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2781
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