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1902404320
SHANELLE LYNETTE RAIFORD
STONE MOUNTAIN, GA
NPI
1902404320
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN245806)
Enumeration Date
2020-10-16
Last Update Date
2020-10-16
Business Address
SHANELLE LYNETTE RAIFORD DNP
2028 HIDDEN MEADOW LN
STONE MOUNTAIN, GA 30088-4448
Phone number: 404-587-0552
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Mailing Address
SHANELLE LYNETTE RAIFORD DNP
2028 HIDDEN MEADOW LN
STONE MOUNTAIN, GA 30088-4448
Phone number:
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